News and updates

Updates on Existing CriteriaJanuary 2025. The following changes to criteria are effective January 22, 2025:Prior Authorization Criteria –...

We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies.We have recently updated our prior authorization list and coverage...

Clarification and update. See frequently asked questions below.Effective January 1, 2024, PacificSource began completing utilization management reviews for...

Updates on Existing CriteriaDecember 2024. The following changes to criteria are effective December 22, 2024:Prior Authorization Criteria –...

Updates on Existing CriteriaDecember 2024. The following changes to criteria are effective December 22, 2024:Prior Authorization Criteria –...

We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies.We have recently updated our prior authorization list and coverage...

Learn the latest and greatest, starting October 8Our yearly Provider Workshops are an important event for healthcare professionals and service providers. You'll get all the updates on our plans and...

Updates on Existing CriteriaNovember 2024. The following changes to criteria are effective November 22, 2024:Prior Authorization Criteria –...

As part of our continued efforts to reinforce accurate coding practices, we are revising the current Emergency Department (ED) outpatient facility Evaluation and Management (E/M) coding reimbursement...

Updates on Existing CriteriaThe following changes to criteria are effective October 22, 2024:Prior Authorization Criteria – Clinical UpdatesArikayce...