News and updates
Added requirements for nuclear medicine and SPECT/CT codes
Effective May 17, 2021, PacificSource Health Plans will require prior authorization for the following nuclear medicine and SPECT/CT codes:...
March 2021 Drug List Change Notification
Updates on Existing Criteria:
March 2021. The following changes to criteria are effective March 22, 2021:
Preauthorization Criteria – Clinical Updates
Arcalyst...
What you need to know about the CAHPS surveys
Your commercial and Medicare patients 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...
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...