News and updates
Pre-payment audits resumed Oct. 15
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...
Philips CPAP/BiPAP recall information
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...
November 2021 Drug list Change Notification
Updates on Existing Criteria:
November 2021. The following changes to criteria are effective November 22, 2021:
Prior Authorization Criteria – Clinical...
October 2021 Drug list Change Notification
Updates on Existing Criteria:
October 2021. The following changes to criteria are effective October 22, 2021:
Prior Authorization Criteria – Clinical Updates...
New for ’22: PacificSource Streamlines Provider Networks
To simplify how members and providers work with us, PacificSource has announced changes to our network beginning Jan. 1, 2022. Once the changes are complete, we will serve members across the region...
September 2021 Drug list Change Notification
Updates on Existing Criteria:
September 2021. The following changes to criteria are effective September 22, 2021:
Prior Authorization Criteria – Clinical Updates...
Update to codes requiring prior authorization
Effective August 30, 2021, PacificSource will require prior authorization for the following codes related to Optical Coherence Tomography for...
August 2021 Drug List Change Notification
Updates on Existing Criteria
August 2021. The following changes to criteria are effective August 22, 2021:
Prior Authorization Criteria – Clinical Updates...
Prior Authorization Criteria – Clinical Updates...
July 2021 Drug List Change Notification
Updates on Existing Criteria
July 2021. The following changes to criteria are effective July 22, 2021:
Prior Authorization Criteria – Clinical Updates
Arcalyst...
Special enrollment period recap
Special enrollment periods (SEP) in Idaho, Montana, Oregon, and Washington began in February or March. SEPs may include consumers on and off the exchange. Because each state has its own rules and...