Effective for dates of service on and after September 12, 2021, the following updates will apply to the AIM Advanced Imaging Clinical Appropriateness Guidelines.   Part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable health care services.

Effective 1/1/21 prior authorization is not be required for transfers to skilled nursing facilities, inpatient rehabilitation centers, and long term acute care hospitals. However, we do require inpatient notification as our Health Services team is performing concurrent review and will require updated notes for continued stay.

Medicare  2% Sequestration Suspension Extended to 12/31/21

We recently modified our Medicare Advantage PPO plans for Members to no longer report their PCP designation to PacificSource. Inadvertently, during implementation, letters were generated and sent to some Members specific to these plans.

If one of your patients has received such a letter, please advise to disregard. We are also sending out letters to members impacted that may have received the letter in error.

Please contact our Customer Service depa
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PacificSource COVID-19 Benefit and Reimbursement FAQ - Updated January 2021

PacificSource Health Plans is dedicated to meeting the needs of our members, including the ability to locate appropriate care. Toward this goal, we are pleased to introduce a new partnership regarding provider data validation to better our Provider Directory. This partnership with BetterDoctor was effective January 2021.

Reminder, effective in January 2019, all PacificSource Medicare Advantage (MA) plans considered the specialties below as eligible for our members.

• Licensed Professional Counselors (LPC)

• Licensed Clinical Professional Counselor (LCPC)

• Licensed Marital and Family Therapists (LMFT)

• Licensed Mental Health Counselors (LMHC)