Articles

Part of being a “members first” health insurer is communicating clearly with members. That’s why we’re pleased to announce a redesign of the Explanation of Benefits (EOB) statement you receive when you use your PacificSource benefits. The EOB provides you with details on what services were...

The Explanation of Benefits (EOB) is a statement that gives members important details on services performed, benefits paid, and payment responsibilities. That’s why we’re pleased to announce a redesign of the EOBs members receive when they use their PacificSource benefits. This new EOB will make...

Being a “members first” health insurer means communicating in ways that members find easy to understand. That’s why we’re pleased to announce a redesign of the Explanation of Benefits (EOB) statements members receive when they use their PacificSource benefits. As you know, the EOB is a fixture of...

Updates on Existing Criteria January 2022. The following changes to criteria are effective January 22, 2022: Prior Authorization Criteria – Clinical Updates Belumosudil – remove stand-alone policy and add to general Oncology Agents criteria ...

Updates on Existing Criteria: December 2021. The following changes to criteria are effective December 22, 2021: Prior Authorization Criteria – Clinical Updates Anti-Cataplectics – rename Oxybates and update to include new Xywav indication of idiopathic...

After a brief pause, PacificSource has resumed auditing pre-payment hospital claims, beginning October 15, 2021.  The policy document is available upon request and your Provider Service Representative is available to answer your questions.

On June 14, 2021, Philips issued a recall notification for specific affected ventilation and sleep apnea devices. The notification informs patients, users, and customers of potential impacts on patient health and clinical use related to this issue.  If you represent a U.S. durable medical...

With our region’s facilities currently overtaxed by COVID-19 patients, a major flu outbreak this fall would be especially dangerous. Current guidance from the CDC states that “everyone 6 months and older should get a flu vaccine every season with rare exceptions.” What can you do to help? Simple...

Updates on Existing Criteria:  November 2021. The following changes to criteria are effective November 22, 2021: Prior Authorization Criteria – Clinical Updates Alemtuzumab – update required medical information and prescriber restrictions ...