February 2021 Drug List Change Notification
Updates on Existing Criteria:
February 2021. The following changes to criteria are effective February 22, 2021:
Preauthorization Criteria – Clinical Updates...
News and updates
UDS definitive drug testing code change
Effective January 1, 2021, PacificSource will allow testing codes G0480, G0481, G0482 and G0483 for members covered by our commercial plans. These...
Preauthorization change for colonoscopy procedures
Effective January 1, 2021, preauthorization will no longer be required for CPT codes 00811 – 00813 for members covered by our commercial plans....
January 2021 Initial Claim Rejections
Effective January 1, 2021, PacificSource will be implementing additional industry standard rejections that will occur at our front door once they pass through the...
January 2021 Drug List Change Notification
Updates on Existing Criteria:
January 2021. The following changes to criteria are effective January 22, 2021:
Preauthorization Criteria – Clinical Updates...
2021 Commercial sales materials are now online
The 2021 commercial brochures, summaries, and summary of benefits and coverage documents (SBCs) are now on our website. These materials are specific to Idaho, Montana, Oregon, and Washington.
Please...
December 2020 Drug List Change Notification
Updates on Existing Criteria:
December 2020. The following changes to criteria are effective December 22, 2020:
Preauthorization Criteria – Clinical Updates...
Telehealth Reimbursement and Behavioral Health Update
Reiterating our policy for telehealth services reimbursement and addressing requests for Behavioral Health telehealth, post-pandemic.
Annual changes to prior authorization requirements
Every year prior authorization requirements are subject to change; some codes are added while others are removed. Please see our prior authorization grid to confirm whether a service requires a prior...
When Members Ask You About Flu Shots, Please Tell Them This
“Get one.” That’s it, plain and simple.As part of our annual anti-...