Provider Newsletter Archive

Miss the latest issue of our newsletter for participating providers? You can access the most recent copies here in our archives.

Winter 2017

(February 9, 2017)

Web Page

General Information:

  • Urgent vs. Emergent Preauthorization Requests
  • PacificSource Policy on Retroactive Rate Adjustment
  • Quality Corner

Commercial News:

  • Telehealth Service Guidelines

Medicaid and Medicare News:

  • Enrollee Rights Reminder
  • Central Oregon Resources for Diabetes Prevention
  • Medicaid Benefits That May Surprise You
  • New Workgroup Aims to Improve Hypertension Control

Fall 2016

(September 20, 2016)

Web Page

General Information:

  • PacificSource Honored with American Heart Association Platinum Fit-friendly Worksite Award 
  • Dr. Kristen Dillon Named Oregon Family Doctor of the Year 
  • DME Fee Schedule Change Reminder 
  • Fall Workshops Coming Soon! 
  • Save Time and Work More Efficiently with InTouch! 
  • Discounted 2017 Code Books 

Commercial News and Information:

  • PCP Names Removed from Commercial ID Cards

Medicaid and Medicare News:

  • New Oregon CCO Incentive Measure: Cigarette Smoking Prevalence
  • Genetic Testing Reminder for Medicare and Medicaid Patients

Spring 2016

(March 14, 2016)

Web Page

General Information:

  • Community Health Excellence Program Now Accepting Application
  • Quality Corner
  • Helpful Tips to Improve HEDIS Performance: Breast Cancer Screening
  • Oregon Contraceptive Mandate
  • Annual Surveys Measure Member Experience with their Health Plan and Providers
  • 2016 CMS DMEPOS Fee Schedule Changes

Commercial News and Information:

  • Deep Sedation Preauthorization for Endoscopies
  • Commercial Provider Manual Updates

Medicare News:

  • Depression in Newly Diagnosed Older Adults
  • Medicare Billing News and Reminders

Medicaid News:

  • Medicaid Provider Manual Update

Autumn 2015

(October 23, 2015)

Web Page

General Information:

  • ICD-10 – We're live!
  • PCP Referral Requirement Discontinued in 2016 for Most Plans
  • Online Directory Requirements
  • Locum Tenens Policy Updated
  • Claims News
  • Risk Adjustment: A Key Component in Quality Patient Care
  • Coram Remains Preferred Provider for Home and Specialty Infusion Services
  • Quality Improvement Program Fosters Effective and Safe Patient Care
  • Clinical Practice and Preventive Health Guidelines
  • Case Management Provides Support for Members with Complex or Chronic Conditions
  • Utilization Management (UM) Information for Providers
  • Affirmative Statement about Incentives
  • Pharmacy Program Annual Notice
  • Member Rights and Responsibilities 

Commercial News and Information: 

  • HEDIS Reporting Requires Medical Record Collection
  • Condition Support Program Information Included in Provider Manual
  • Commercial Provider Manual Updates
  • Updated Guides and Documents Available Online 

Medicaid Specific: 

  • Promoting Dental Care During Pregnancy

Medicare Specific: 

  • Medicare Preventive Visit Requirements
  • POS Code Changes for Outpatient Hospitals 

Summer 2015

(June 25, 2015)

Web Page

General Information:

  • New Vendor Brings Changes to EOPs, EOBs, and Claim Payment Options
  • InTouch News: Reports Feature Added
  • Chronic Care Management (CCM) Guidelines
  • Quality Corner
  • ICD-10: How an Electronic Health Record Can Streamline Implementation
  • Introducing Michael Franz, Behavioral Health Medical Director
  • PacificSource Invests in Local Communities

Commercial News: 

  • Commercial Provider Manual Updates

Medicaid Specific: 

  • Keeping You Updated with Medicaid Conversion

Medicare Specific: 

  • New Partnership Helps Bridge Gaps in Care
  • Use of HCPCS Modifier PO
  • Avoiding Medicare Fraud and Abuse

Spring 2015

(April 2, 2015)

Web version | Print-friendly PDF

General Information:

  • Upcoming Workshops 
  • InTouch for Providers – Benefit Page Changes
  • Documentation with an Eye on ICD-10 
  • Accessibility of Services for Primary Care, Emergent or Urgent Care, and Behavioral Health 
  • Please Welcome Dr. Alison Little, MD, MPH
  • Administrative News and Reminders -
    Referral Changes Simplify Process for Providers and Members 
    Please Don't Share User IDs and Passwords for OneHealthPort 

Commercial News: 

  • Commercial Provider Manual Updates

Medicare Specific: 

  • Changes to the PacificSource Medicare Member ID Card
  • CMS Pneumococcal Vaccinations: Modifications to Medicare Part B Coverage
  • Medicare Coding Reminders 
  • Billing for Annual Wellness Visit (AWV) and Annual Physical Exam 
  • PacificSource Medicare Inpatient Post-Payment Review

Medicaid Specific: 

  • Health Care Interpreter (HCI) Services
  • Screening, Brief Intervention, and Referral to Treatment (SBIRT) screenings
  • Coordinated Care Organization (CCO) Fraud, Waste, and Abuse (FWA) Audit 
  • Community Solutions Refund Process 
  • Medicaid Operations Conversion Announcement

Winter 2015

(January 7, 2015)

Web version | Print-friendly PDF

General Information:

  • InTouch News -
    2015 Brings Exciting Site Improvements!
    Online Data Security Threat Leads to Website Improvements 
  • ICD-10 Costs May Be Lower than Expected
  • Administrative News -
    Modifier 59 and the New X Modifiers 
    Ambulatory Surgery Centers (ASC)
    Discounted 2015 Code Books Still Available 

Commercial News: 

  • Commercial Chart Review Initiative Begins
  • Peer-to-peer Policy Change
  • Nicotine Free Elective Spinal Fusion Procedures
  • Commercial Provider Manual Updates
  • New Vision Care Service
  • Oregon Law Changes OTJ-related Claims Processing

Medicare Specific: 

  • New Member ID Cards Issued for 2015 Plan Year
  • Medicare Annual Wellness Visits
  • Annual Medicare Compliance Training Clarification

Autumn 2014 

(October 15, 2014)

Web versionPrint-friendly PDF

  • Community Health Excellence: Helping People Get Better Care
  • New Claim Payment Option: Virtual Credit Card (VCC)
  • First Choice Network
  • ICD-10 Final Rule News
  • Upcoming Workshops
  • Administrative News -
    Use Caution with Modifiers PA, PB, and PC
    Use Rendering Provider Name to Avoid Unnecessary Claim Denials
    Preauthorization Request Checklists
  • Latest Notices and Updates
  • Electronic Submission Requirements for Pharmacy Prior-authorization Requests
  • Elective Induction of Labor (Commercial)
  • 90-day Retro Preauthorization (Commercial)
  • Vision Service Plan to Be Offered as Plans Renew Starting in January 2015 (Commercial)
  • Commercial Provider Manual Updates (Commercial)
  • Billing for Capped Durable Medical Equipment (DME) (Medicare)
  • L1 Modifier and Separately Billable Lab Fees (Medicare)
  • Risk Adjustment: A Key Component in Quality Patient Care (Medicare)
  • Member Engagement Project – OHP Timely Reenrollment (Medicaid)

Summer 2014 

(July 9, 2014)

Web versionPrint-friendly PDF

  • ICD-10 Delay: Our Plan and the Latest News
  • PacificSource Diabetes Support Programs Address Growing Health Issue
  • Administrative News
  • Claims Processing Changes Due to ACA’s Nondiscrimination Provision (Commercial)
  • Nonreimbursed Nursing Level Charges During an Acute Care Hospital Stay (Commercial)
  • Drug Formulary and Coverage Changes Effective July 1, 2014 (Commercial)
  • Guidelines for Global Surgery Billing (Medicare)
  • Concierge-Style Customer Service Program Begins for Members (Medicare)
  • Part D Payment for Drugs for Beneficiaries Enrolled in Hospice (Medicare)
  • Improper Use of ABN (Medicare)
  • Medicare Advantage Chart Review Initiative Continues (Medicare)
  • Referral Guideline Update (Medicaid)
  • Claims Processing Edit Updates (Government Claims Corner)
  • Urological Supplies and Medicare Billing Guidance (Government Claims Corner)

Spring 2014

(April 10, 2014)

Web versionPrint-friendly PDF

  • ICD-10 Delayed for at Least a Year
  • Network Strategy Team Builds Partnerships to Improve Health
  • Spring Provider Workshops
  • Administrative News and Reminders
  • Retroactive Referrals Policy Change (Commercial)
  • Successful Member Outreach Program to Continue (Medicare)
  • New PacificSource Community Solutions Provider Manual (Medicaid)
  • And more 

Winter 2014

(January 8, 2014)

  • ICD-10: The Value of Physician Engagement
  • PacificSource Wins American Heart Association's Community Innovation Award
  • Quality Improvement Program
  • HEDIS Reporting Requires Medical Record Collection
  • Clinical Practice and Preventive Health Guidelines
  • Utilization Management Information for Providers
  • PacificSource Health Plan’s Affirmative Statement about Incentives
  • Pharmacy Program Annual Notice
  • Member Rights and Responsibilities
  • Health Services Staff Support Your Patients
  • In Memoriam - Board Member Steve Lynch
  • Administrative News and Reminders 

Autumn 2013

(November 11, 2013)

  • Healthcare Reform Brings about New Plan Designs
  • Changes to ID Cards
  • 24-Hour NurseLine Now Available
  • New Provider Service Representatives
  • Retrospective preauthorization policy change
  • Standard Practice Guidelines Available Online
  • Availability of Clinical Criteria
  • Diagnostic Imaging Management Now in All States
  • Address or Staffing Changes? Please Let Us Know
  • Provider Manual Updates
  • Discounted 2014 Code Books Still Available
  • New Large Employer Clients
  • PacificSource Performance at a Glance 

Summer 2013

(July 26, 2013)

  • Healthcare Reform Update: What’s on the horizon?
  • ER physician to Serve as Idaho and Montana Medical Director
  • ICD-10: Ready or Not, Here It Comes!
  • New CMS-1500 Claim Form
  • Prescription Drug Information at Your Fingertips, 24/7
  • Separate Checks Please
  • Changes? A Friendly Reminder to Keep Us Informed
  • Timely Referrals Ensure Uninterrupted Patient Care 

Spring 2013

(April 15, 2013)

  • ICD-10 Is Coming—Are You Ready?
  • Diagnostic Imaging Management Program Expanding
  • Medication Therapy and “The Licorice Mystery”
  • Survey Finds Electronic Claims Speed Processing Time
  • We’re Not in It for Trophies, But This One Sure Is Nice!
  • Provider Manual Updates
  • Description Change on 835 Transaction Files
  • Staff Email Addresses Changed to Keep Pace with Growth
  • Separate Toll-free Numbers for Commercial and Medicare Members
  • Discounted 2014 Code Books Now Available 

Winter 2013

(January 4, 2013)

  • You Asked, We Listened: Eligibility Data Enhancements
  • InTouch Online Authorization Tools Now Even Easier to Use
  • Standard Practice Guidelines Aid Health Decisions
  • Stay Informed about Reform
  • HEDIS Reporting Requires Medical Record Collection
  • Condition Support Newsletters
  • Administrative News & Reminders

Autumn 2012

(October 19, 2012)

  • Volunteers in Medicine Partnership Helps Central Oregonians
  • New Medical Director Welcomes Physician Communication
  • CHE Award Recipients for 2012 – 2013
  • Million Ideas Blog Seeks Your Input to Move Healthcare Forward
  • New Columbia Gorge CCO Aims to Improve Community Health
  • Changes and New Program Help Members with ESRD
  • City and Zip Code Change Fast Approaching
  • Many Members to Receive New ID Cards
  • Get Paid Faster with Electronic Payments
  • Code Books Still Available
  • Credentialing Process Improved
  • Documentation Checklists to Improve Preauthorization Turnaround Times
  • Medicare Advantage Provider Workshops Coming Soon
  • New Large Employer Clients
  • PacificSource Performance at a Glance - Sept 2012

Summer 2012

(July 23, 2012)

  • Medical Home: Moving from Concept to Reality
  • OMHA Agreement Ending in September
  • PacificSource Remains Committed to Reform
  • Welcome New Provider Service Representatives!
  • Administrative News & Reminders
  • Secure Email to Change on August 25
  • Multiple Surgery Reductions
  • Help Patients Save by Using In-Network Labs
  • Spinal Traction Devices No Longer Covered
  • Discounted 2013 Code Books Now Available
  • Idaho Claims Address
  • Reminder: Our PO Boxes Addresses Have Changed
  • New Large Employer Clients
  • PacificSource Performance at a Glance 

Dental Bulletin - Summer 2012

(July 3, 2012)

  • What Coordinated Care Organizations (CCOs) Mean for Dentists
  • New PacificSource Dental Products Coming Soon
  • What Constitutes Cosmetic Dentistry?
  • Fluoride Varnish Benefit Expanded
  • Claims for Crowns and Bridges
  • PacificSource Fraud and Abuse Policy
  • Direct Phone Line for Faster Service

Spring 2012

(April 10, 2012)

  • PacificSource Helps College Campuses Go Tobacco-free
  • InTouch Updated, Online Referral Requests Now Available
  • PacificSource Gains New Members in Montana
  • Members to Benefit from Condition Support Program Change
  • Community Health Excellence Program (CHE) Now Accepting Applications
  • Healthy KidsConnect Outpatient Rehabilitation Therapy Clarification
  • OIG Workplan Offers Wealth of Helpful Information

Winter 2012

(February 2, 2012)

  • Executive VP and CMO Joins PacificSource
  • On the Move
  • Healthy KidsConnect Changes
  • Temporary ID Cards Now Available
  • Low Back Pain Program
  • Credentialing Process Changes
  • New Address for PO Boxes
  • HEDIS Requires Medical Record Collection
  • Clarification of Immunization Admin Codes
  • COB Claims May Now Be Sent Electronically
  • Keeping Emailed Member Information Secure

Autumn 2011 

  • InTouch Upgraded
  • Online Preauthorization
  • Medicare Update
  • Clear One Healthy KidsConnect Plan Ending
  • CHE Named “Health Care Hero”
  • PSA to Process Claims for Shared Care
  • Prenatal Vitamin Program Extended
  • HIPAA Version 5010 Requires Physical Address
  • Preventive Care Clarifications
  • Preauthorization List Updated
  • Purpose of Policy Reconsideration Form

Dental Bulletin - December 2011

  • PacificSource Renews Commitment to Dental Market
  • Dr. Gary Allen Provides Dental Consulting Expertise
  • Prior Authorizations Help Avoid Surprises
  • Criteria for Coverage of Periodontal Scaling and Root Planing
  • New Voluntary Dental Plan
  • The Advantage Dental and PacificSource Partnership
  • PacificSource Performance at a Glance
  • Questions? We're Happy to Help

ProviderBulletin - Summer 2011

  • PacificSource Promotes Nutrition in Oreg. Classrooms
  • OneHealthPort: Register without Personal Information
  • Administrative News
  • Newsletter Going Electronic
  • PacificSource Performance at a Glance
  • On the Move: Debbie Smith and Terry Goodman
  • Process Change for Diagnostic Imaging Requests
  • New Large Groups
  • Provider Manual Updates
  • Discounted Code Books

ProviderBulletin - Spring 2011

  • Improving Health through Clearer Communication
  • Medical Home Project
  • Network Change for Eastern Washington
  • Medicare and Medicaid Update
  • CHE Now Accepting Applications
  • New Employer Clients
  • Depression Screenings Now Covered
  • Provider Manual Updates
  • PacificSource Performance at a Glance
  • Administrative News and Reminders
  • 2012 Code Book Order Form

ProviderBulletin - Winter 2011

  • PacificSource Achieves High Scores in First HEDIS Report
  • Provider Network Welcomes New Representatives, Modifies Territories
  • Healthcare Reform Update
  • POS Takes Guesswork Out of Preventive Care Copays
  • Clear One Acquisition Update
  • AIM Implementation Update
  • Prescription Drug List Improvements
  • New Employer Clients  

Dental Bulletin - December 2010

  • The Advantage Dental and PacificSource Partnership
  • Healthy KidsConnect and the Oregon Health Plan
  • Clear One Healthy KidsConnect Moving to Advantage Network
  • Changes to InTouch Access for Providers
  • Policy for Payment on Crown Build-ups
  • Alternate Procedures on Crowns
  • NEA - A Convenient, Cost-effective Way to Send Claims Attachments
  • Tips for Fast Claims Turnaround

Autumn 2010 ProviderBulletin

  • Back Surgeries Will Soon Require Preauthorization
  • Imaging Management Program Reminder
  • CHE 2010 Grantees
  • Montana Members Change Networks
  • Administrative News and Reminders
  • Provider Manual Updates

Summer 2010 ProviderSource

  • Community Health Excellence Program Off to a Great Start
  • Clear One E-Updates
  • Healthcare Reform Information
  • Weight Watchers Program
  • New Imaging Management Program
  • Upgrades to InTouch and Online Provider Directory
  • Facility Claims Editing Now in Effect
  • 2011 Code Books Available at Discount Prices

Spring 2010 ProviderSource

  • Healthy KidsConnect Program
  • Update on our Acquisition of Clear One Health Plans
  • New Format for Drug List
  • Facility Claims Editing Coming Soon
  • Carmel Anderson Joins Credentialing Team
  • Our Condition Management Program Is Changing
  • Modifier 25 Policy Clarification
  • And more...

Winter 2010 ProviderSource

Correction: On page 2 of this issue we stated incorrectly that providers can use payor ID 93029 for PacificSource Administrators (PSA) claims. Please use payor ID 93031 for all PSA claims and 93029 for PacificSource Health Plans claims.

  • SBA is now PacificSource Administrators, Inc.
  • Important information for IPN providers
  • HEDIS reporting
  • Free prenatal vitamin program
  • Tobacco cessation and weight management programs
  • And more...

Autumn 2009 ProviderSource

  • Community Health Excellence initiative
  • POS Direct offers e-claims submission
  • New H1N1 codes
  • Idaho provider network changes
  • New technology improves preauthorization process
  • Practice guidelines added to PacificSource.com
  • PacificSource performance
  • Administrative news & reminders
  • Provider manual updates
  • Code book order form deadline extended
  • And more...

Summer 2009 ProviderSource

  • Point of Service Direct makes estimating claims easy
  • Treatment Cost Navigator helps members estimate medical costs
  • Provider manual updates
  • Epocrates provides mobile access to Rx information
  • Improved security for e-mail containing PHI
  • Corrected claim reminder
  • And more...

Spring 2009 ProviderSource

  • New look for PacificSource.com
  • PacificSource welcomes PHP members
  • ICD-10 implementation delay
  • Preauthorization list update
  • Claims direct deposit date change
  • PacificSource performance at a glance
  • 2010 code book ordering
  • Laboratory handling codes and modifier updated
  • SBA adds Emdeon
  • And more…

Winter 2009 ProviderSource

  • Ringing in 2009/Provider Network
  • PacificSource Performance at a Glance
  • Preauthorization List Changes
  • Overpayment Auto-Recovery Process Improves Efficiency
  • SBA Claims and Service
  • Online ProviderSource Newsletter Provides Additional Information
  • And more…

Autumn 2008 ProviderSource

  • System Upgrade Completed!
  • Welcome Peter McGarry as Director of Provider Network
  • Never Events Policy
  • Welcome Jacklyn Steward to Contracting
  • Provider Service Representatives on the Move
  • Healthy Returns™ Expands
  • Preauthorization List Change
  • Educational Opportunities
  • And more...

September 2008 ProviderSource

  • Special Edition: How Our Technology Upgrade Affects You
  • System Upgrade Coming Next Month
  • Changes for SBA Members

Summer 2008 ProviderSource 

  • System Upgrade—Preparing for the Next Phase
  • 2009 Code Books Available
  • Sally Hales Leads Provider Network Team
  • Meet Renea DiDomenico, Provider Service Representative
  • PDA Access to Formularies
  • Healthy at Heart™ and Diabetes Control Network Discontinued
  • New Corrected Claims Form
  • Educational Opportunities
  • And more...

Spring 2008 ProviderSource 

  • Technology News: InTouch online portal; NPI
  • Program News: Prenatal care program changes
  • Staff News
  • Administrative News: Updated preauthorization list and preferred drug lists
  • Other News: PacificSource's 75th anniversary; new PacificSource clients; Oregon FHIAP program cuts
  • Opportunities: Educational opportunities; community events

Winter 2008 ProviderSource 

  • Technology News: Updates on PacificSource's System Upgrade and InTouch Online Portal for Providers
  • Program News: AlternaCare Savings Program Added; Tobacco Cessation Program Extended
  • Staff News: New Provider Service Representatives
  • Administrative News: Updated Provider Directory, Provider Manual, Preauthorization List, New Medical Technologies
  • Other News: Portland Office to Relocate; PacificSource Honored With Community Award; New PacificSource Clients
  • Opportunities: Educational Opportunities; Community Events

Autumn 2007 ProviderSource

  • Technology Upgrade Update
  • Our Provider Service Representatives
  • New Short Term Medical Product
  • Boise Open House Celebrates Growing Network
  • Staffing News: Lisa Zent, Stephanie Meyer
  • 2008 Code Books Available
  • Administrative News
  • Community Events
  • Educational Opportunities
  • Professional Liability Coverage for Complementary Care
  • New Technologies
  • Our Performance at a Glance
  • New Large Employer Groups

June 2007 Special Edition ProviderSource

  • Technology Upgrade Brings Changes
  • New PacificSource Member ID Cards
  • New EOPs
  • NPI Reminder

June 2007 Special Edition DentalSource 

  • Technology Upgrade Brings Changes
  • New PacificSource Member ID Cards
  • New EOPs
  • Changes to Current Dental Terminology
  • NPI Reminder
  • Dental Preauthorization Available Online

Spring 2007 ProviderSource 

  • Meet Portland's New Provider Contract Lead
  • NPI Doesn't Replace Tax ID
  • Technology Updates
  • Hospital-Based Wellness Classes
  • Service Representatives
  • Billing Form Changes
  • Emergency and After-Hours Codes
  • Preauthorization Change/Clarification
  • Provider Manual Updates
  • New Technologies Update
  • New Large Employer Group Clients

PacificSource newsletters are provided for general informational purposes only and do not supersede the provisions of any underlying health plans or contracts which may be in effect.

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Last updated 2/10/2017