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.
Phone
888-691-8209
TTY: 711
FAX
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