Updates on Existing Criteria
May 2023. The following changes to criteria are effective May 22, 2023:
Prior Authorization Criteria – Clinical Updates
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The Centers for Disease Control, Oregon Health Authority, and the Centers for Medicare and Medicaid Services recommend clinicians carefully assess benefits and risks of prescribing high doses of...
PacificSource has updated the following clinical policies:
Instrumented Spinal Surgery
Ocular Remodeling
Sleep Disorder Treatment
See our Clinical policies and practice guidelines for the full...
Updates on Existing Criteria
April 2023. The following changes to criteria are effective April 22, 2023:
Prior Authorization Criteria – Clinical Updates ...
Effective April 1, 2023, the following HCPC codes will require prior authorization (PA) when using the Durable Medical Equipment (DME) benefit.
A9276
A9277
A9278
E2102
E2103
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 Press...
Updates on Existing Criteria
March 2023. The following changes to criteria are effective March 22, 2023:
Prior Authorization Criteria – Clinical Updates ...
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...
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...