News and updates

Updates on Existing Criteria February 2024. The following changes to criteria are effective February 22, 2024: Prior Authorization...

All claim-status checks must be completed using our secure provider portal, InTouch for Providers (OneHealthPort). We will no longer accept Claim Status Request forms submitted via...

Effective March 1, 2024, alternative care providers contracted through The CHP Group will no longer be considered in-network. Instead, PacificSource will begin contracting directly with alternative...

Currently, continuous glucose monitors are covered under both durable medical equipment (DME) and pharmacy benefits. Effective January 1, 2024, we are transitioning all therapeutic CGMs to the...

Updates on Existing Criteria January 2024. The following changes to criteria are effective January 22, 2024: Prior Authorization Criteria – Clinical...

Certain codes will require prior authorization for Oregon Medicaid members.

Beginning November 13, 2023, PacificSource will use different criteria for level-of-care decisions for mental health treatment (including inpatient, residential, partial...

Clarification and update. See frequently asked questions below. Effective January 1, 2024, PacificSource will begin completing utilization management reviews for members who have...

Updates on Existing Criteria December 2023. The following changes to criteria are effective December 22, 2023: Prior Authorization Criteria – Clinical Updates...

We have recently updated our prior authorization list and coverage policies. This change is effective for dates of service on or after November...