Revised PCP Referral Approval Timeline

10/1/2014 3:01:29 PM

We would like to inform you of changes regarding PCP referral approval timelines for PacificSource Community Solutions. Historically, we have given PCP offices 10 calendar days to approve a specialist initiated referral in the CIM portal. After reviewing response times for PCP offices, we noted that most offices review referral requests within 5 days.

Therefore, effective November 1, 2014, PCP offices will have 5 calendar days to approve specialist initiated referrals. This change in policy is intended to provide the specialist and member faster determination notice and expedite delivery of care.

For questions, contact your PacificSource Provider Service Representative at (800) 624-6052 ext. 2580 or email providerservicerep@pacificsource.com.


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