Premera accepts electronic claims and inquiry/request transactions either by direct submission or from selected clearinghouses.
Sending electronic claims and inquiry/request transactions offer several advantages:
Sending electronic claims is accomplished via Secure Transport and by logging into our web site: www.connectiva.com. Secure Transport is a product of the Tumbleweed Communications Corp that allows the transfer of files through a secure Internet connection. It utilizes the standard security protocol of HTTPS and integrates SSL and Digital Certificate (X.509). It is a field-proven, complete solution that allows for the reliable delivery of both large and small files.
Your access to connectiva.com will be through a One Health Port (OHP) User ID number, which you may already have. Please register for an OHP User ID at www.onehealthport.com.
Premera Secure Transport services include:
ST is available 24 hours a day, 7 days a week.For questions regarding your Secure Transport connection, contact our EDI Team at 800-435-2715.
Premera accepts claims for the following:
The following claim types may be billed electronically:
Currently, PBC uses ANSI 837 Healthcare Claim ASC X12N Version 4010A1 for the claim types below:
Note: ANSI 837 Healthcare Claim ASC X12N Version 5010 will be mandated for use on June 30, 2012.
The EDI (Electronic Data Interchange) process will return a 997 (Functional Acknowledgement transaction) and Electronic Claims Transaction Reports to the submitting entity. For more information about 997s see HIPAA/EDI FAQ.
Electronic Reporting provides the following:
Note: Reports are posted electronically at www.connectiva.com.
A corrected/replacement claim is any claim that has changes or corrections to one of the following:
Providers should submit a corrected or replacement claim electronically using the HIPAA 837 standard claims transaction, and include the following information:
A free-form note with an explanation for the Corrected/Replacement Claim, in Loop 2300 ‘Claim Note’, as:
For Professional & Dental Claims, segment NTE01 must contain ‘ADD’ and segment NTE02 must contain the note, Example: NTE*ADD*CORRECTED PROCEDURE CODE
For Institutional Claims, segment NTE01 must contain ‘UPI’ and segment NTE02 must contain the note, Example: NTE*UPI*CORRECTED LAB CHARGES
(Seattle Office)Telephone: 800-435-2715 option 1Fax: 425-918-4234
Telephone: 800-435-2715 option 2Fax: 509-532-6352EDI@premera.com
Telephone: 800-435-2715 option 3Fax: 541-318-2337EDI@premera.com
Premera Blue CrossP.O. Box 327Mail Stop 481, EDISeattle, WA 98111-0327
Premera Blue CrossMail Stop 4817001 220th Street SWMountlake Terrace, WA 98043-2124
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