Latest Notices and Updates

If you have questions about any of the information on this page, you're welcome to contact us. For claim questions, as well as member benefits and eligibility information, please contact our Customer Service team at (888) 977-9299. For provider issues, please contact your Provider Service Representative or call (855) 896-5208. 

Provider Survey on our 2017 Tobacco Cessation Campaign

Last November, as part of our annual tobacco cessation campaign, we created a flier and video for healthcare providers. We’d like your feedback on these materials as well as on our tobacco cessation program, Quit for Life. 

The survey has 7 questions and should only take about 5 minutes to complete. 

Thank you for your time and valuable input. Your responses will help us improve our tobacco cessation outreach efforts in the future. 

Click here to take the survey >

Attend Our January 17 HEDIS Audit Webinar

Please join us for our workshop webinar focused on the 2018 Healthcare Effectiveness Data and Information Set (HEDIS) Audit. We’ll outline how to prepare for the 2018 audit and answer your questions. The webinar is free and should last about 90 minutes.

Have questions now? Email them to your Provider Service Representative by January 12 so we can tailor the webinar topics to your needs.

Registration deadline: January 12, 2018

On the registration page, register for the online webinar for January 17, 2018, at 9:00 A.M. Pacific Time.

Register Now!

After you register, you will receive an email with the call-in information.

If you are unable to register online or have questions, please email us at, or call

  • Oregon Providers: (800) 624-6052 ext. 1457
  • Idaho and Montana Providers: (800) 624-6052 ext. 1459 

Read the Fall Issue of the Provider Bulletin

The Fall issue of our Provider Bulletin is now available. In this issue:

  • The Conversation that Saves Lives: Tobacco Cessation
  • Prescription Assistance Programs and Benefit Verification
  • Administrative News & Reminders

Subscribe to our Provider Bulletin e-newsletter! You can subscribe or unsubscribe at any time. We value your privacy

New Provider Course: Exercise Therapy as an Alternative to Opioids for Chronic Mechanical Low Back Pain

Starting in January 2018, Colin Hoobler, PT, DPT, MS, and a team of contributing physicians1 are leading a course to teach primary care physicians and other health care providers (FNP, PA-C, ND, DC) how to practically apply science to exercisesuch as biomechanics, anatomy, and neuroscienceto treat patients with chronic, mechanical low back pain (MLBP) as an alternative to opioids, as well as those who are opioid-addicted. There will be five opportunities in 2018 to participate in this course.

The course will focus on how to synthesize clinical rehabilitation principles with medical research to yield practical clinical skills. Through evidence-based motivational and clinical time-sensitive techniques, participants will learn to help patients assume greater responsibility for their health and hold physical therapists accountable for evidence-based care when treating patients with chronic pain, especially those who may be addicted.

Pending approval, participants may earn two CME-approved AMA PRA Category 1 Credits  per class via Preventive Health Awareness, an Oregon-based 501(c)(3).

Sign Up for the First Class

Date: Saturday, January 27, 2018, from 10:00 a.m. to noon

Location: c.h. Physical Therapy Clinic in Beaverton, OR

Class size is limited to 25 participants. It is $95 to take the course with all proceeds going through a local 501(c)(3), Preventive Health Awareness, and profits donated to local charities. Profits from January's class will be donated to Saint Mary's Home for Boys. The cost of the course includes a textbook on exercise prescription.

Reserve your spot. >> 

1 Kathy Alvarez, MD; Tanya Carter, DO; Greg Gullo, MD; Andy Harbison, MD; Jordi Kellogg, MD; Michelle Mears, MD; Bart Rask, MD; Matt Rose, DO; Robert Sandmeier, MD

Office Service Claims

August 23 Update

PacificSource had previously changed its Provider-based Billing Policy (see original notice below) regarding office services. Now, we allow these claims with dates of service on or after August 1, 2017. Thank you for your patience and cooperation. If you have any questions about this change, you're welcome to contact your Provider Service Representative or our Provider Services team:

Idaho and Montana: (541) 246-1459 
Oregon: (541) 246-1457 

Original Notice

Please be aware, all office services submitted with dates of service on or after May 1, 2017, must be billed under the service provider, in an ANSI 837P format (CMS 1500), and with the “office” place of service (POS).

Effective May 1, 2017, PacificSource will no longer accept provider-based billing of office services, regardless of the office location. We will deny as noncovered any office services billed on a UB claim form, and you will need to resubmit them in the correct format.

Claims in the following formats are not reimbursable: 

  • Claims billed with revenue codes 051X
  • Evaluation and Management codes (CPT 99201-99215 and HCPC G0463) that are billed with revenue codes 0760 through 0769
  • Claims with a “PO” modifier

Thank you for your cooperation. If you have any questions about this change, you’re welcome to contact your Provider Service Representative or our Provider Services Department:

Idaho and Montana: (541) 246-1459
Oregon: (541) 246-1457 

Discounted 2018 Code Books

June 2017 - You can pre-order 2018 code books through us at a discounted rate, and delivery is free! Simply complete the order form and mail it to us with your payment. Payment in full is required at the time of order.

Orders will be accepted through December 31, 2017. Please see our Provider Forms and Materials page for the order form (Administrative Forms section).

Changes to Drug Testing Policy for Commercial Plans

June 2017 - Recent changes to our urine drug testing policy may affect your patients with PacificSource commercial coverage. This change does not apply to PacificSource Community Solutions (Medicaid) or PacificSource Community Health Plans (Medicare) coverage. Read the full notice: Changes to drug testing policy (PDF).  

Change to Chart Retrieval Calls

As you may know, PacificSource is currently retrieving charts for the 2017 HEDIS submission. The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool health plans use to measure things like care and service. ArroHealth may have contacted you to request a chart retrieval. 

New vendor
We will also work with CiOX Health, which will assist ArroHealth to collect remaining charts.

What to expect
In the coming days, a CiOX Health representative may contact you. They will walk you through how to send your charts to them, whether it is by mail, fax, remote, or on-site retrieval. It’s okay if you already sent your charts to ArroHealth. ArroHealth will manage your charts, and it will be as if there was no change in chart retrieval vendor. If CiOX contacts you, and you already sent your charts to ArroHealth, simply let the CiOX representative know.

Please contact us with any questions or concerns you may have. You can call your Provider Network representative, or you’re welcome to contact Patricia Grady, HEDIS Program Manager, at (541) 330-7331 or  

Facility Claims Require Full Code Number

Effective January 26, 2017, PacificSource will start denying facility claims that are billed without the required 4th/5th digit. If the DX code requires it and the provider didn’t bill it, the entire claim will deny (regardless of where the DX falls on the claim – could be primary DX or could be the 5th DX). This is already being done on Medicare/Medicaid facility and professional claims, and will now apply to facility claims for our commercial members. These incorrectly coded claims have an impact on reporting and risk adjustment. Please contact your Provider Service Representative if you have any questions.  

NDC Codes Required for Drug Claims Starting February 1

Effective February 1, 2017, we will require National Drug Code (NDC) numbers on all drug-related HCPC/CPT codes, including unlisted drug codes. Please see our NDC FAQ for details.

Are Your Claim CPT Codes Up to Date?

Please double check your claim CPT codes to make sure they are current. Beginning January 1, 2017, claims with termed CPT codes will be denied. Note that there is no longer a grace period.

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.

Healthcare Reform 

Questions about the Affordable Care Act? You'll find information, FAQs, and links to online resource in our Healthcare Reform Resource Center.


InTouch for Providers

Access your PacificSource account information 24/7.

Medicaid Dental Providers

Learn more about our contracted dental provider networks for Medicaid dental services.

Learn more >



Questions about ICD-10?

See our FAQ.


Your Provider Service Representative

Your PacificSource Provider Service Representative is available any time you have a question or concern. If you're not sure who your representative is, please visit our Provider Service Staff Directory.

Last updated 1/10/2018