Provider BulletinPacificSource logo

November 2, 2017

In this issue:

The Conversation that Saves Lives: Tobacco Cessation >

Prescription Assistance Programs and Benefit Verification >

Administrative News & Reminders >  


The Conversation that Saves Lives: Tobacco Cessation

Despite a decline in smoking rates over the past few decades, tobacco use is still the number one preventable cause of death and disease in the United States. The good news is that conversations between patients and their healthcare team about tobacco cessation can significantly increase patient quit attempts, according to a 2013 study published in The Oschner Journal

You may already be using motivational techniques like the 5 A’s or 5 R’s with your patients, but as you know it can be challenging when you encounter resistance. Typical roadblocks to quitting tobacco include: withdrawal symptoms, stress, fear of weight gain, and lack of support. 

To help you and your medical staff address these and other barriers, we’ve created a new flier, “Tobacco Use Intervention: Rolling with Resistance” (pdf) as well as a short video on the same topic. 

In addition, we encourage you to learn about Quit For Life®, our tobacco cessation program, and share our Quit For Life flier (pdf) with patients who have PacificSource coverage.

While healthcare providers have more opportunities for direct contact, PacificSource is also inviting members to talk about quitting tobacco through our blog and other social media platforms. You can read “The Quitter’s journey,” a three-part series, at:


Prescription Assistance Programs and Benefit Verification

If you occasionally recommend prescription assistance programs to help patients afford higher priced medications, please remind them to call CVS Caremark® (our contracted specialty pharmacy) to verify pharmacy benefits first—or offer to do this form them—rather than refer them directly to the manufacturer or pharmacy. 

We commonly receive calls from both drug manufacturers and noncontracted specialty pharmacies asking for member information and benefits. Unfortunately, we cannot give out this member information. The company then usually calls your office back with questions, resulting in delays for the member and extra work for your staff.

Otezla and Gilenya Support are two drug companies that frequently contact us. Others include The Lash Group, McKesson Specialty, Synergy RX, Accredo, Avella, TNH, Diplomat, Sindara, Biologics Inc., Cardinal Health Specialty, Rx Crossroads, and Optum Specialty. Examples of patient assistance plans include Genentech, Access Solutions, and Patient Access Network/PAN. 


Administrative News & Reminders

Discounted 2018 Code Books Still Available

Still need 2018 code books? We offer these to participating providers at a discounted rate, and there is no charge for delivery. Simply complete our 2018 Code Book Order Form (pdf) and mail it to us with your payment. Payment in full is required at the time of order.

Time-Based Codes

To ensure timely payment of claims, please remember to provide documentation of start and end times when billing for time-based codes. Claims without this documentation will be denied. Thanks for your attention to this detail. 


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