News and updates

Effective April 1, 2023, the following HCPC codes will require prior authorization (PA) when using the Durable Medical Equipment (DME) benefit. A9276 A9277 A9278 E2102 E2103

Your commercial and Medicare clients may be asked to participate in the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey is overseen by a company called Press...

Updates on Existing Criteria March 2023. The following changes to criteria are effective March 22, 2023:  Prior Authorization Criteria – Clinical Updates ...

Effective March 1, 2023, AIM Specialty Health® is changing its name to Carelon Medical Benefits Management. PacificSource partners with AIM to administer prior authorizations for nonemergency...

With a new year comes new benefit questions, and with it, higher call volumes—which could lead to longer hold times. While we’re always happy to assist you over the phone, we know your time is...

Washington State providers now have a new direct phone to reach PacificSource Provider Services: 888-224-3556, TTY: 711. We accept all relay calls. Contact Provider Services for...

All PacificSource Community Solutions (OHP/Medicaid) claims with 2023 dates of service will be held while we validate correct pricing and benefits. This hold also applies to Medicare Advantage...

All providers and their staff are required to complete the Compliance & FWA Training annually. Please review the PacificSource Code of Conduct and the PacificSource Compliance and Program...

Updates on Existing Criteria February 2023. The following changes to criteria are effective February 22, 2023:  Prior Authorization Criteria – Clinical Updates...

Beginning in early 2023, PacificSource will use different criteria for level-of-care decisions (inpatient, residential, partial hospitalization, and intensive outpatient) for mental health treatment...