News and updates
OHLC shares guidelines for behavioral health via telehealth
The Oregon Health Leadership Council (OHLC) has created a guideline document for Telehealth Service Recommendations for Behavioral Health.
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Clinical policy changes
PacificSource has updated the following clinical policies:
Instrumented Spinal Surgery
Ocular Remodeling
Sleep Disorder Treatment
See our Clinical policies and practice guidelines for the...
AIM Specialty Health changing name to Carelon Medical Benefits Management
Effective March 1, 2023, AIM Specialty Health® is changing its name to Carelon Medical Benefits Management. PacificSource partners with AIM to administer prior authorizations for nonemergency...
New direct phone for Washington providers
Washington State providers now have a new direct phone to reach PacificSource Provider Services: 888-224-3556, TTY: 711. We accept all relay calls.
Contact Provider Services...
Medicaid and Medicare Advantage claims pay hold
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...
Annual Compliance Training
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...
Behavioral health criteria changes delayed
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...
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines
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...
See what’s new with our website’s provider section
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...
Genetic Testing Guideline Changes – Effective March 11, 2023
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...