Latest Notices and Updates


Critical Access Hospitals (CAH) and Rural Health Centers (RHC)


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Clarification of 2019 PT,ST and OT cap limits
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As a provider, you’re able to prescribe skilled nursing facility (SNF) care without the customary three-day hospital stay. 


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Duplicate 1099's
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All Medicare Advantage claims with 2019 dates of service are being held while we validate correct pricing and benefit configuration.  We anticipate these claims will be released by the end of this week.  
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Electronic Prior Authorization/InPatient Notification 2019
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Opioid Overutilization Initiative Program Effective January 1, 2019.
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This notification is to inform you of changes to our medical drug formulary for all PacificSource Medicare, Medicaid, and Commercial Plans.

 

Effective on 01/01/2019 our formulary will change


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CMS is placing a claims payment hold on all Inpatient and Long Term Care claims with discharge dates 10/1/18-10/22/18
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Inpatient Stay Update – only one IP reference number per stay.


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