News and updates
On Behalf of OHA- Provider billing and member reimbursement for retroactive OHP Supplemental Benefits
To reimburse OHP members who paid your office for OHP Supplemental benefits now retroactively covered, please be sure to bill the member's coordinated care organization (CCO), dental care...
January 2023 Drug List Change Notification (Commercial)
Updates on Existing Criteria
January 2023. The following changes to criteria are effective January 22, 2023:
Prior Authorization Criteria – Clinical Updates...
The winter edition of The Source newsletter is here
The Source is sent to in-network providers, with content ranging from educational articles, trends, resources, and important news for providers. The winter 2022 issue will highlight...
Claims Status Checks now provided ONLY via InTouch For Providers
All Claim Status checks must be completed using our secure provider portal, InTouch for Providers. Please visit OneHealthPort.com to sign up or log in.
For claims status...
Diagnostic Digital Breast Tomosynthesis - CPT G0279
Effective 11/11/2022 PacificSource Community Solutions will no longer pay/reimburse for CPT G0279 (Diagnostic digital breast tomosynthesis; unilateral or bilateral).
CPT code G0279 has not been an...
Genetic Testing Guideline Changes – Effective March 11, 2023
Effective for dates of service on and after March 11, 2023, AIM Specialty Health® (AIM) will transition to an updated set of Clinical Appropriateness Guidelines.
PacificSource...
PacificSource...
EPSDT coverage will be expanded in Oregon beginning January 1, 2023
Sharing on behalf of OHA:
Oregon will not renew the longstanding waiver around EPSDT for children. The decision comes as a result of clear feedback from the community, advocates, children's...
December 2022 Drug List Change Notification
Updates on Existing Criteria
December 2022. The following changes to criteria are effective December 22, 2022:
Prior Authorization Criteria – Clinical Updates...
Learn about RxDC Reporting
According to CMS, RxDC Reporting is intended to enhance transparency and shed light on how prescription drugs contribute to the growth of healthcare spending and the cost of health coverage.* To...
November 2022 Drug List Change Notification
Updates on Existing Criteria
November 2022. The following changes to criteria are effective November 22, 2022:
Prior Authorization Criteria – Clinical...