On behalf of OHA we are sharing this information to keep our providers informed and current with any changes made. This Information is specific to Oregon Health Plan physical and behavioral health providers.
COVID-19 Emergency Declaration Health Care Providers Fact Sheet
Billing Dual Covered Members - PacificSource Medicare Advantage and Community Solutions
LogistiCare Solutions - Effective date April 1, 2020
PacificSource is proactive in moving claims electronically, and we encourage providers to consider electronic billing opportunities.
Some of the benefits providers can realize by transmitting claims electronically are:
Faster reimbursement. By eliminating the time it takes for mailing, internal routing, and data entry, claims are in our system much faster, and are in line for payment sooner.
Reduced costs. Electronic billing saves pr
Oregon Health Plan (OHP) Members receive dental benefits through Dental Care Organizations (DCOs). All OHP Members have dental benefits. PacificSource CCO Members receive dental benefits through the following DCO partners in all PacificSource regions:
Capitol Dental Care
For questions regarding participation status please contact our Customer Service teams or your Provider Service Representative.
Medicaid Member PCP and DCO assignment for the new CCO areas for Lane, Marion and Polk Counties is in progress. Providers needing to submit new Prior Authorizations within our Provider Portal (InTouch) we are advising to wait until 1/6/20.
Medicaid Members showing assigned in error to Kaiser has been resolved.
PacificSource Community Solutions is happy to announce our Health Care Interpreter (HCI) partners effective 1/1/20.
We are wanting to ensure our providers are updated regarding our Medicaid members starting with PacificSource Community Solutions with an effective date of 1/1/20 for Lane, Marion and Polk.
Pharmacy Coverage Updates Effective January 15, 2020
Pharmacy Coverage Updates Effective October 1, 2019
Effective July 1, 2019 Vision Therapy will require a prior authorization (PA). Vision therapy is covered for children through age 20, with a covered diagnosis per the Prioritized List of Health Services.
Effective 11/1/2019 PacificSource Community Solutions will start denying provider claims for providers that are billing with either their Tax-ID number or Social Security Number (SSN) if the information billed doesn’t match what the State has on file. Updates must be made through us PacificSource Community Solutions .
Pharmacy Coverage Updates Effective June 15, 2019
Effective 5/20/2019, PacificSource will not be requiring a PA with the associated codes: