News and updates

All claim-status checks must be completed using our secure provider portal, InTouch for Providers (OneHealthPort). We will no longer accept Claim Status Request forms submitted via...

Certain codes will require prior authorization for Oregon Medicaid members.

Clarification and update. See frequently asked questions below. Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have...

We have recently updated our prior authorization list and coverage policies. This change is effective for dates of service on or after November...

Here’s what you need to know: Coverage of Humira (adalimumab) through PacificSource Community Solutions will change to other, biosimilar formulations. Will I still be able to prescribe Humira?...

PacificSource Community Solutions (Medicaid) allows a 20-day skilled nursing facility (SNF) stay for individuals who qualify for skilled care. Prior authorization is not required for admission to a...

Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have received 26 or more therapy/counseling...

For Medicaid plans: Effective November 1, 2023, a prior authorization will be required for CPT Code 26055 (Tendon Sheath Incision).

We would like to inform you of changes to our PacificSource Community Solutions formulary and coverage policies. ...

These updated documents contain policy guidance for the Medicaid Grievance and Appeals System. The changes will also be included in the next update of our Provider Manual. ...