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Criteria for prior authorization decisions

Criteria may be requested by contacting our Health Services team. Criteria can be emailed, faxed, or mailed to you per your request.



TTY: 711


Oregon: 541-225-3625
Idaho: 208-333-1597
Montana: 406-441-3378


PacificSource Health Plans
Attn: Health Services
PO Box 7068
Springfield, OR 97475-0068

Inpatient admission notification and utilization review

We require notification of all inpatient hospital admissions. Notification allows for timely and effective discharge planning as well as the identification of patients in need of case management.

Submission of inpatient admission notification and utilization review must be initiated via your online provider portal, InTouch for ProvidersFor step by step instructions on how to submit, please reference our InTouch for Providers Resource Guide.