Provider Notices

COVID-19 FAQ for Providers: Reimbursement, Telehealth, and More - Updated June 3, 2020

Read More

Effective July 1, 2020 Prior Authorization (PA) requirements are being set on dental codes 41899 Unlisted Proc, Dentoalveolar Structures and 00170 Anesthesia, Intraoral Proc, W/Bx; Nos.  A PA will need to be submitted along with the DCO approval letter. Without a PA and DCO approval letter the request will be subject to a denial. Please call PacificSource Community Solutions if you have any questions.

Read More

PacificSource Community Solutions is implementing process changes for non-emergent ambulance transportation rides and how they should be requested and provided to our members, in each of our CCO regions.

Read More

On behalf of OHA we are sharing this information.

Read More

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

Read More

 

Medicaid Provider Stability Payments

 

In collaboration with the Oregon Health Authority, PacificSource is in the process of issuing provider stability payments to support providers who serve our CCO members and who rely on fee-for-service payments from PacificSource. This is intended to offset financial impacts on providers due to the COVID-19 pandemic.

 

Read More

PacificSource Community Solutions is working to support our members and communities during this pandemic. We have implemented the following to support providers in this time of uncertainty:

• Eased operational burdens on providers

• Expanded telehealth billing policies

• Distributed early payments under 2019 risk arrangements

• Distributed 2019 quality incentive “early release” funds made available by
  
  Read More

Pre-Approval requirement for Repetitive Transcranial Magnetic Stimulation (rTMS)

Read More

Medicaid Therapy FAQ

Read More

On behalf of OHA we are sharing this information.

Read More

Free Online Disaster Behavioral Health Training for Health Care Professionals & First Responders

Read More

On behalf of OHA we are sharing this link that includes detailed information to keep our providers informed and current with any changes made. 

Read More

Medicaid PA Removals for “S” codes, IV Home Infusions and Intravitreal injections.

Read More

Provider Relief Plan

Read More

Pharmacy Coverage Updates April 15, 2020 and June 15, 2020

Read More

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.

Read More

COVID-19 Emergency Declaration Health Care Providers Fact Sheet

Read More

COVID-19 Action Plan and Coding Guidance

Read More

The PacificSource Credentialing team has recently updated our policy on the Medicaid Validation application process.

Read More

Billing Dual Covered Members -  PacificSource Medicare Advantage and Community Solutions

Read More

LogistiCare Solutions - Effective date April 1, 2020

 

Read More

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
  
  Read More

Effective 2/17/2020 - New Prior Authorization Requirements for Neurophyscological Exam and Testing

Read More

Pharmacy Coverage Updates March 15, 2020

Read More

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:

• Advantage Dental

• Capitol Dental Care

• Read More

Auth Grid and Clinical Criteria

Read More

For questions regarding participation status please contact our Customer Service teams or your Provider Service Representative.

Read More

We have received an influx number of member calls to our Provider Service phone queue. In an effort to best help our members’ please refer them to our Customer Service Department, as we strive to provide first call resolution for our members.

Read More

For PacificSource Community Solutions Advanced Imaging Prior Authorizations need to be submitted via our Provider Portal (InTouch). All Genetic Testing Prior Authorizations effective July 1, 2019 are submitted to AIM.

Read More

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.

Read More

For Dates of Service 2.2.2020 and after OHA requires that providers bill out of hospital delivery/births to the state directly.

Read More

Medicaid Members showing assigned in error to Kaiser has been resolved.

Read More

Medicaid Member PCP and DCO assignment for new CCO areas for Marion, Polk, and Lane Counties is in progress.  In addition, some members are showing as assigned to Kaiser in error.  DCO Assignment is also still in progress.  Thank you for your patience while we get this issue resolved. 

Read More

PacificSource Community Solutions is happy to announce our Health Care Interpreter (HCI) partners effective 1/1/20.

 

Read More

 

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.

Read More

We are no longer including members assigned Primary Care Provider (PCP) on our Member ID cards.

Read More

Pharmacy Coverage Updates Effective January 15, 2020

Read More

2020 Non-Emergent Medical Transportation by CCO Region

Read More

Change in Provider Contract Effective Dates - Effective January 1, 2020

Read More

PacificSource Community Solutions invites our provider partners to participate in our upcoming provider training. The focus will be about the PS BHI clinical model and requirements for reimbursement, including self-attestation, site reviews and reporting requirements for receiving a PMPM when fidelity standards of BHI are met.

Read More

PacificSource Community Solutions invites our provider partners to participate in our upcoming provider training. The focus will be around onboarding our providers to ensure providers can best serve our Medicaid members. These webinars will take place over the phone and online. This will allow for providers and/or staff to attend from the convenience of their offices.

Read More

Pharmacy coverage changes

Read More

PacificSource Community Solutions (PSCS) is requesting proposals to convene and facilitate a System of Care governance structure to provide oversight for Wrap Around services in Marion County and Polk County.

Read More

Pharmacy Coverage Updates Effective December 15, 2019

Read More

PacificSource Community Solutions (PSCS) is requesting proposals to convene and facilitate a System of Care governance structure to provide oversight for Wrap Around services in Wasco County and Hood River County.  

Read More

Vaccines For Children - Modifier SL

Read More

Pharmacy Coverage Updates Effective October 1, 2019 

Read More

Effective October 1, 2019 Centers for Medicare and Medicaid Services (CMS) will put into effect a new classification for Skilled Nursing Facilities (SNF).

Read More

New Prior Authorization Requirements for Contact Lens Fitting Effective 8/12/19

Read More

Lane, Marion, Polk, Gorge and Central Oregon CCOs expected to be awarded

Read More

Behavioral Health InPatient Notification

Read More

Non-Covered Medicare Service

Read More