Articles

PacificSource Health Plans is committed to supplying members with accurate, up-to-date directories of our network providers. Last year, PacificSource Health Plans entered into a partnership with BetterDoctor to improve our provider directories and streamline the data validation process. At that...

Updates on Existing Criteria July 2022. The following changes to criteria are effective July 22, 2022: Prior Authorization Criteria – Clinical Updates Carglumic acid – update required medical information and appropriate treatment regimen for each covered...

Please join us in welcoming Michelle Lauerman, our new Sales Executive serving Portland and other Oregon clients. She joined the Portland office team April 18. Michelle has more than 20 years in the insurance industry, creating and selling commercial products. Most recently,...

Updates on Existing Criteria June 2022. The following changes to criteria are effective June 22, 2022: Prior Authorization Criteria – Clinical Updates Abilify Maintena – added requirement of established tolerability to oral aripiprazole Actimmune – added dose...

Effective June 15, 2022, PacificSource will require prior authorization for Continuous Glucose Monitoring for members on our commercial plans. This change pertains to CPT codes 95250 and 95251. Visit our Prior Authorization Resources page for more information.

Updates on Existing Criteria: May 2022. The following changes to criteria are effective May 22, 2022: Prior Authorization Criteria – Clinical Updates ...

Access to Care Survey is now conducted by phone  As a provider, you understand how access to care is vital to healthy communities. As required by Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA), PacificSource conducts periodic phone surveys...

Updates on Existing Criteria April 2022. The following changes to criteria are effective April 22, 2022: Prior Authorization Criteria – Clinical Updates Botox – update appropriate treatment regimen to include coverage for anal fissures Dalfampridine – Update...

PacificSource has removed the prior authorization requirement for mental health and substance use disorder residential and partial hospitalization treatment. This change is for our commercial members only.  If you have questions, please contact us at: 
888-691-8209, TTY: 711. We accept all...