News and updates

Effective August 30, 2021, PacificSource will require prior authorization for the following codes related to Optical Coherence Tomography for...

Updates on Existing Criteria August 2021. The following changes to criteria are effective August 22, 2021:
Prior Authorization Criteria – Clinical Updates...

Updates on Existing Criteria July 2021. The following changes to criteria are effective July 22, 2021: Prior Authorization Criteria – Clinical Updates Arcalyst...

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...

The American Rescue Plan (ARP) Act of 2021 includes COBRA subsidies and increases dependent care account maximums to help Americans. COBRA premium assistance Individuals may have 100% of COBRA...

Updates on Existing Criteria: June 2021. The following changes to criteria are effective June 22, 2021: Prior Authorization Criteria – Clinical Updates Botox –...

Effective March 15, 2021, prior authorization for deep sedation will no longer be required for: 
•    Upper endoscopy,
•    Colonoscopy,...

Effective January 21, 2021, when processing claims, PacificSource will follow ICD-10-CM guidelines on inappropriate diagnosis combinations. The current guideline states, “'An...

PacificSource Health Plans and PacificSource Community Solutions are notifying providers of COVID-19 vaccine reimbursements for dates of...

Applications received April 1–30 will have an effective date of May 1, 2021.  This applies to:  New and existing enrollees On...