Latest Notices and Updates
If you have questions about any of the information on this page, you're welcome to contact your Provider Service Representative or call (855) 896-5208.
Noninvasive prenatal testing (NIPT) of cell-free fetal DNA (cfDNA)
PacificSource is committed to following evidence-based guidelines and practices for noninvasive prenatal testing of cell-free fetal DNA. Read a letter about our commercial policies (PDF).
Durable Medical Equipment Update
Effective June 1, 2016, the Durable Medical Equipment reimbursement in your contract will reference the 2016 Centers for Medicare & Medicaid Services DMEPOS Fee Schedule. This change, as allowed by your contract, will bring your payment in line with Centers for Medicare & Medicaid Services pricing. This update will affect you unless you have an extended term or other special language tying payment to a specific fee schedule. Please contact your Provider Service Representative if you have any questions.
Read the Spring Issue of the Provider Bulletin
The Spring issue of our Provider Bulletin is now available. Our Community Health Excellence (CHE) Program is now accepting applications. Read about CHE, quality measures, tips to improve HEDIS performance, the Oregon contraceptive mandate, member surveys, and more!
Subscribe to our Provider Bulletin e-newsletter! You can subscribe or unsubscribe at any time. We value your privacy.
2016 CMS DMEPOS Fee Schedule
01/12/16 - Centers for Medicare & Medicaid Services (CMS) significantly changed the reimbursement for Durable Medical Equipment, Prosthetic and Orthotics (DMEPOS), effective January 1, 2016. Changes include application of Competitive Bidding Program rates and rural and nonrural differential based on Zip code.
PacificSource provider contracts reference the CMS DMEPOS Fee Schedule for these services and products. Due to the complexity and timing of the release of the 2016 fee schedule, PacificSource will continue to reimburse for these services at the October 2015 CMS DMEPOS Fee Schedule for the state referenced in the provider contract until further notice. We will continue to assess the changes and communicate by notice or amendment as appropriate.
PacificSource and Legacy Health – A Partnership to Build a Healthier Future for Northwest Communities
10/26/15 - We’re proud to announce that PacificSource Health Plans and Legacy Health are pursuing a partnership to bring together complementary capabilities. Our shared vision of healthcare focuses on improving the experience of care, reducing healthcare costs, and improving the health of our communities.
Ultimately, this partnership was driven by both organizations’ commitment to serve both members and patients.
Important Things to Know about this Partnership
- We will maintain all our provider partnerships. We will continue to work with all our existing provider partners throughout Oregon, Idaho, and Montana. We will also continue to pursue future relationships with other healthcare providers.
- No change to existing provider contracts, processes, policies, programs, or staff. Please be assured that our processes, such as preauthorization and claims payment, will continue as usual. In addition, our name and brand will remain the same.
- For members, nothing has changed. Members will continue to receive the same outstanding benefits and unmatched customer service that have been hallmarks of PacificSource since 1933.
- As we move forward, the partnership will provide the foundation for improvements and enhancements. This includes increased access to care for communities, the creation of new and unique health plan offerings, and industry-leading stability in a volatile health insurance market.
Looking for more information? You’re welcome to read the news release or our FAQ for providers to learn more about Legacy Health and this partnership.
Questions about the Affordable Care Act? You'll find information, FAQs, and links to online resource in our Healthcare Reform Resource Center.