News and updates

All PacificSource Community Solutions (OHP/Medicaid) claims with 2023 dates of service will be held while we validate correct pricing and benefits. This hold also applies to Medicare Advantage...

All providers and their staff are required to complete the Compliance & FWA Training annually. Please review the PacificSource Code of Conduct and the PacificSource Compliance and Program...

Updates on Existing Criteria February 2023. The following changes to criteria are effective February 22, 2023:  Prior Authorization Criteria – Clinical...

Beginning in early 2023, PacificSource will use different criteria for level-of-care decisions (inpatient, residential, partial hospitalization, and intensive outpatient) for mental health treatment...

Effective for dates of service on and after April 9, 2023, the following updates will apply to the AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines.  As part of the AIM...

To better serve our provider partners, we are proud to announce several enhancements to PacificSource.com, with the aim of helping you connect with the information you need more easily and...

As you may already be aware, Uprise Health, formerly known as Reliant Behavioral Health (RBH), has decided to terminate their contract with PacificSource. Please disregard this notice if you...

Effective for dates of service on and after March 11, 2023, AIM Specialty Health® (AIM) will transition to an updated set of Clinical Appropriateness Guidelines.  PacificSource has...

Uprise Health, formerly known as Reliant Behavioral Health (RBH), recently announced they are terminating their contract with PacificSource Health Plans. Uprise Health is an independent provider...

To reimburse OHP members who paid your office for OHP Supplemental benefits now retroactively covered, please be sure to bill the member's coordinated care organization (CCO), dental care...