News and updates
AIM Specialty Health changing name to Carelon Medical Benefits Management
        
      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...
  
      
Avoid high call volumes and save time with our online tools
        
      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...
  
      
New direct phone for Washington providers
        
      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...
  
      
Medicaid and Medicare Advantage claims pay hold
        
      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...
Annual Compliance Training
        
      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...
  
      
February 2023 Drug List Change Notification (Commercial)
        
      Updates on Existing Criteria
February 2023. The following changes to criteria are effective February 22, 2023: 
Prior Authorization Criteria – Clinical...
  
      
Behavioral health criteria changes delayed
        
      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...
  
      
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines
        
      Effective for dates of service on and after April 9, 2023, the following updates will apply to the AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines. 
As part of the AIM...
  
      
See what’s new with our website’s provider section
        
      To better serve our provider partners, we are proud to announce several enhancements to PacificSource.com, with the aim of helping you connect with the information you need more easily and...
  
      
Urgent Notice for Uprise Health (formerly known as RBH) contracted providers
        
      As you may already be aware, Uprise Health, formerly known as Reliant Behavioral Health (RBH), has decided to terminate their contract with PacificSource. Please disregard this notice if you...