Latest Notices and Updates
PacificSource and Legacy Health – A Partnership to Build a Healthier Future for Northwest Communities
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.
Read the Autumn Issue of the Provider Bulletin
The Autumn issue of our Provider Bulletin is now available. ICD-10 is now live. Read about the 2016 change to the PCP referral requirement and more!
Subscribe to our Provider Bulletin e-newsletter! You can subscribe or unsubscribe at any time. We value your privacy.
Locum Tenens Policy Updated
PacificSource will now accept modifier Q5/Q6 locum tenens claims. Our Provider Network department will monitor all claims that come in with Q5 or Q6 modifier to ensure they are within the locum tenens claim guidelines. A locum tenens arrangement is made when a participating provider must leave his or her practice temporarily due to illness, vacation, leave of absence, or another reason.
A locum tenens who provides coverage for a participating provider for up to 60 days does not require credentialing with PacificSource. If the locum tenens leaves the practice and then returns to the practice for an additional cycle, a new 60-day cycle will be allowed before credentialing is required. However, if the locum tenens provides coverage longer than 60 consecutive days, the applicable practitioner credentialing application is mandatory for claims consideration.
Locum tenens claims billed after the 60-day period without the completion of credentialing will be denied. Claims would need to include the names of the locum tenens or the servicing provider for the claim to pay according to member’s benefits and contractual guidelines.
Discounted 2016 Code Books Now Available
As a participating provider, you can preorder code books through PacificSource at a discounted rate—and delivery is free! To order, simply complete the 2016 Code Book order form and mail it to us with your check. Full payment is required prior to delivery.
Questions about the Affordable Care Act? You'll find information, FAQs, and links to online resource in our Healthcare Reform Resource Center.