Physician and Provider Manual
PacificSource Commercial Plans
The PacificSource Physician and Provider Manual is your desktop reference for information about PacificSource commercial policies and procedures. It can also be used as a training tool when familiarizing new employees to PacificSource. Updates are announced in The Provider Bulletin newsletter and on the For Providers - Welcome page of this website.
Please take a moment to look over the sections that relate to your responsibilities.
If you have any questions or suggestions regarding this manual, you are welcome to contact your PacificSource Provider Service Representative.
Updates: Sections 3, 8, 9, and addenda updated January 2017.
Complete Commercial Provider Manual with state-specific covered expenses, general exclusions, and limitations.
For a faster download time and to easily find what you're looking for, you can also follow the links below to view a specific chapter of the Provider Manual.
Table of Contents
Section 1 Introduction
Section 2 Who to Contact
Section 3 Glossary of Terms (updated January 2017)
Section 4 Physicians and Providers
Section 5 Referrals
Section 6 Medical Management
Section 7 Pharmacy
Section 8 Products (updated January 2017)
Section 9 Members (updated January 2017)
Section 10 Filing Claims
Section 11 Billing Requirements
Section 12 Publications and Tools
Idaho Covered Expenses, General Exclusions, and Limitations (updated January 2017)
Montana Covered Expenses, General Exclusions, and Limitations (updated January 2017)
Oregon Covered Expenses, General Exclusions, and Limitations (updated January 2017)