News and updates
What you need to know about the CAHPS surveys
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 SPH...
Provider Notice: Billing for COVID-19 vaccines
Please note that providers may bill PacificSource for the administration of the vaccine, but not for the vaccine itself, which is paid for by the federal government. If you...
Reporting requirement for providers using offshore contractors
PacificSource is required to meet standards set by multiple federal and state regulators as well as accrediting standards and contractual obligations to various groups. As a contracted entity of...
Maternity stay notifications no longer required
Effective January 1, 2021, PacificSource will be removing inpatient notification requirements for maternity hospital stays for members on all commercial and Medicaid plans. If...
ACA reporting for 2020: deadlines and details
Employers, health insurers, and individuals will soon need to prepare for filing their 1094 and 1095 forms with the IRS. Here’s what you need to know to assist your clients with this requirement:...
February 2021 Drug List Change Notification
Updates on Existing Criteria:
February 2021. The following changes to criteria are effective February 22, 2021:
Preauthorization Criteria – Clinical Updates...
UDS definitive drug testing code change
Effective January 1, 2021, PacificSource will allow testing codes G0480, G0481, G0482 and G0483 for members covered by our commercial plans. These...
Preauthorization change for colonoscopy procedures
Effective January 1, 2021, preauthorization will no longer be required for CPT codes 00811 – 00813 for members covered by our commercial plans.
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January 2021 Initial Claim Rejections
Effective January 1, 2021, PacificSource will be implementing additional industry standard rejections that will occur at our front door once they pass through the...
January 2021 Drug List Change Notification
Updates on Existing Criteria:
January 2021. The following changes to criteria are effective January 22, 2021:
Preauthorization Criteria – Clinical Updates...