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
Our second event of the Acute Pain Prescribing Guidelines Learning Series is for primary care, emergency care, and dental/oral surgery providers as well as supporting care teams.
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:
Currently 43248 Upper GI Endoscopy w/insertion of Guide Wire/Dilatation requires a Prior Authorization (PA). Effective April 15, 2019 the PA requirement will be removed. This code will no longer require a PA.
Notice on behalf of the Oregon Health Authority (OHA)
In December, OHA announced
New Provider Enrollment, the State of Oregon will conduct pre-enrollment and post-enrollment site visits for high and moderate risk provider types. You can find more information regarding this new process on the below link to OHA’s website.
On the behalf of OHA, PacificSource encourages you to visit the below link. Here you will find some great resources offered by OHA, focusing on tobacco dependence treatment in a behavioral health setting.
Urine drug screening reminders for Medicaid Behavioral Health codes
The Oregon Health Authority (OHA) has postponed implementation of Read More