pacificsource patient portal

Where can I find information about PacificSource's provider Bulletin?

Human customer service for you and your employees. For groups of 1-50. Scalable, flexible plans for larger organizations of 51 or more. Health insurance for people who are 65 or older, or those under 65 with certain disabilities or conditions. Health insurance for people with limited incomes.

What is PacificSource InTouch for providers?

PacificSource Health Plans. For more information visit pacificsource.com.. © 2022 PacificSource

What are the benefits of being a PacificSource member?

Oct 01, 2021 · PacificSource Medicare Website. About PacificSource. With a reputation for taking great care of people since 1933, we are known for building relationships and making the extra effort to get to know customers one-on-one.

When is the Medicare enrollment period?

Annual Enrollment Period. (October 15 – December 7) The Annual Election Period runs from October 15 through December 7 each year. During this time, known as the "AEP," you can change plans or enroll in a Medicare Advantage plan for the first time. Coverage for enrollment changes takes effect on January 1.

How long does an IEP last?

Your initial enrollment period (IEP) will be unique to you depending on your birthday. The initial enrollment period lasts seven months: the three months before your birthday, the month of your birthday, and the three months following your birthday.

What is PacificSource benefit verification?

Providing PacificSource with all the information required to provide benefits under their plan. Giving their healthcare provider complete health information to help accurately diagnose and treat them.

What is case management at PacificSource?

Case Management Support and Referrals for Members with Complex or Chronic Conditions#N#Case management is a service available to all PacificSource members who have complex or chronic medical conditions and require support to manage their healthcare needs. It is a service aimed at improving health outcomes and quality of life while reducing healthcare costs.#N#Our case managers are registered nurses and licensed mental health professionals with extensive clinical experience. They work collaboratively with members and their healthcare providers to provide improved clinical, humanistic, and financial outcomes for members.#N#Case management can be of great help to members experiencing a wide range of complex medical issues with extensive care needs. If you would like to refer a patient to case management, please contact our Health Services Department at 888-691-8209.

What are the rights of a member?

Members have a right to participate with their healthcare provider in decision-making regarding their care. Members have a right to know why any tests, procedures, or treatments are performed and any risks involved. Members have a right to refuse treatment and be informed of any possible medical consequences.

What is risk adjustment?

Risk adjustment is a methodology used by both the Centers for Medicare and Medicaid Services (CMS for Medicare Advantage) and Health and Human Services (HHS for commercial plans) to predict healthcare needs and costs based on the overall health of patients. Under the Affordable Care Act (ACA), all Medicare Advantage and commercial plans are required to submit information on patient health status annually to help establish the costs of patient care for the next year and reimbursement to the health plan.

What is CMS in Medicare?

The Center s for Medicare and Medicaid Services (CMS) requires all Medicare Advantage organizations and health insurance carriers to conduct a monthly outreach to all contracted providers to verify provider accessibility for Medicare Advantage or commercial members.

Why do Medicare Advantage plans need to submit health status?

Under the Affordable Care Act (ACA), all Medicare Advantage and commercial plans are required to submit information on patient health status annually to help establish the costs of patient care for the next year and reimbursement to the health plan. But risk adjustment is much more than a regulatory requirement.

What time does the RN office open?

Our offices are open 8:00 a.m. to 5:00 p.m., Monday through Friday. Please contact our Provider Credentialing Department if you have general credentialing questions, or you would like to check the status of credentialing or re-credentialing.

What is PacificSource Intouch?

PacificSource InTouch for Providers is a secure, providers-only area of our Web site. Once you are registered, you can access personalized information about your PacificSource patients and their claims 24 hours a day.

Do I need to register for Intouch?

If you are already a registered user of OneHealthPort, you do not need to register to access InTouch.

How to contact Pacificsource Dental?

For more information on prior authorization, member benefits, eligibility, and other topics, please use the following contact methods: 866-373-7053. dental@pacificsource.com. Contact our provider service representatives.

How many new CDT codes will be added in 2020?

CDT code additions, deletions, and changes were determined for 2020 during the March 15, 2019 meeting of the Code Maintenance Committee. Thirty-seven new CDT codes will be added and six current codes will be deleted. Fifteen of the new codes are implant codes and eight are orthodontic codes.

What is the OAR for telemedicine?

To be eligible for coverage, telemedicine services must comply with: Oregon Administrative Rules (OAR) 410-120-1200 (excluded services and limitations), OAR 410-130-0610 (Telemedicine). This rule is being updated and will be linked to this communication when published with the Secretary of State.

When will 99441 be retroactive?

These codes are newly eligible for payment (retroactive to January 1, 2020) when the service is:

What is evaluation management?

Evaluation and management services (for providers who can perform these services, such as physicians, physician assistants or nurse practitioners), or. Assessment and management services (for other types of providers including behavioral health providers and dietitians).

Does a CCO cover telemedicine?

Yes. If the service falls under those described in Guideline Note A5 in the HERC guidelines. CCOs may cover additional telephone/ telemedicine services. Contact the patient’s CCO for specific guidance on their telephone/telemedicine/telehealth services and policies.