News and updates
On Behalf of OHA- Provider billing and member reimbursement for retroactive OHP Supplemental Benefits
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...
Claims Status Checks now provided ONLY via InTouch For Providers
All Claim Status checks must be completed using our secure provider portal, InTouch for Providers. Please visit OneHealthPort.com to sign up or log in.
For claims status...
Diagnostic Digital Breast Tomosynthesis - CPT G0279
Effective 11/11/2022 PacificSource Community Solutions will no longer pay/reimburse for CPT G0279 (Diagnostic digital breast tomosynthesis; unilateral or bilateral).
CPT code G0279 has not been an...
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...
PacificSource...
EPSDT coverage will be expanded in Oregon beginning January 1, 2023
Sharing on behalf of OHA:
Oregon will not renew the longstanding waiver around EPSDT for children. The decision comes as a result of clear feedback from the community, advocates, children's...
Pharmacy Coverage Updates Effective October 15, 2022
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 policies. These...
Durable Medical Equipment Prior Authorization Requirements Effective 10/1/22
Effective October 1, 2022, a prior authorization requirement will be added to Durable Medical Equipment (DME) that are not on OHA's fee schedule, are set to manual pricing, and/or are designated as...
Pre authorization requirement update
Pre authorization requirement update
Effective August 29, 2022 pre authorization is required for codes 96116, 96121, 96132, 96133, 96136, 96137, and 96146
Please visit the authorization grid to...
Prior Authorization requirement on CPT 97010 - Effective 8/19/22
Prior Authorization requirement on CPT 97010 - Effective 8/19/22
Beginning July 1, 2022 health care providers reimbursed with state funds will be required to work with certified or qualified health care interpreters
OHA distributed a news release on June 15th indicating that new rules made by the state Legislature’s passage of HB 2359 during the 2021 session related to use of qualified or certified health...