Provider News

  • Keep Your Provider Data Current

    Information to help you ensure you’re meeting federal requirements for provider data.

    Learn more

  • Policy updates

    Find recent medical policy and coding updates and payment policy updates.

    News

  • Online tools and resources

    Tool for Documenting Diabetic Retinal Eye Exam Results | 2/2/2023

    Assist your patients in getting their diabetic retinal eye exam results

    Everything You Need to Know About Your Explanation of Payment | 2/2/2023

    The Explanation of Payment (EOP) gives you information about the adjudication of your claims

    2023 ID Card Guide | 1/5/2023

    Check out the newly updated 2023 Premera ID card guide

    Latest Update to Availity Provider Feedback | 1/5/2023

    Our responses to your feedback from customer service calls, provider support teams, and Availity's online feedback feature

  • More online tools and resources news

  • Individual plans

    Updated Individual Plan Tools and Resources Page | 5/5/2022

    We recently added news forms to the Individual Plan Tools and Resources page

    Everything You Need to Know About 2021 Individual Plans | 1/7/2021

    See resources and training guides for 2021 Individual plans.

  • More individual plan news

  • Company updates

    Supporting Providers in the Health Equity Journey to Improve Patients’ Lives | 10/6/2022

    Premera is working to reduce disparities in health and its determinants that adversely affect excluded or marginalized groups

    Premera Invests $3 Million to Bridge Gaps in Mental Health and Health Equity Access | 9/1/2022

    Premera announced $3 million in grants and sponsorships to 20 organizations across Washington and Alaska

    Premera Perspectives: Satya Sarma, Vice President of Medical Management and Population Health | 5/5/2022

    Learn about Premera’s newest leader and her role to identify ways to address the needs of specific communities

    Fighting Substance Use Disorders with Medication-Assisted Treatment | 4/1/2022

    This is the first article in a series highlighting the importance of medication-assisted treatment and breaking down the stigma of substance use disorder

    Change To The Existing Hospital Bill Audit | 2/24/2022

    Medical records must be submitted within 90 days of the request

    Premera Deepens Connection to Communities with County By County Giving Initiative | 12/2/2021

    Grants awarded in every county and borough throughout Washington and Alaska

  • More company updates news

  • High-value care

    Value-Based Care and Premera Provider Relationships | 3/18/2021

    Relationships built on trust, shared data, and analytics can decrease cost of care and health outcomes.

    Payment Models Shift to Value-Based Care | 12/17/2020

    Healthcare organizations and health plans are shifting from care models built around fee-for-service reimbursement to value-based care.

  • More high-value care news

  • Reminders and updates

    Keep Your Provider Data Current | 3/2/2023

    Information to help you ensure you’re meeting federal requirements for provider data

    AIM Specialty Health Transitioned to Carelon | 3/2/2023

    AIM Specialty Health changed its name to Carelon Medical Benefits Management on March 1, 2023

    How To Submit Admission Notification | 3/2/2023

    Information to help you ensure you’re meeting federal requirements for provider data

    AIM Specialty Health Transitions to Carelon | 2/2/2023

    AIM Specialty Health will have a new name, Carelon, on March 1, 2023

  • More reminders and updates news

  • Quality programs

    Helping Patients Who Use the Emergency Department for Migraines | 3/2/2023

    Learn about informative migraine materials you can share with your patients

    Outreach Mailings to Members with Children | 2/2/2023

    Premera is reaching out to members to keep children on track with vaccines and checkups

    High Blood Pressure Educational Mailing | 12/2/2022

    Premera is providing members with winning tips for a healthy heart

    October Care Gap Member Outreach | 10/6/2022

    Outreach to members includes well-child checkups, cancer screening, reduced ED utilization, and improved care for chronic conditions

  • More quality programs news

  • Pharmacy

    Kroger- Express Scripts Termination Reminder | 1/5/2023

    We encourage members to sign in to the Premera member portal to find other local, in-network pharmacy options

    Kroger Removal from Express Scripts Standard Networks | 11/3/2022

    Learn about impacted pharmacies and how it may affect your patients

    2023 Essential Drug Exclusion List | 11/3/2022

    Starting January 1, 2023, some drugs will change to preferred status, and some have been added to the Essential Drug Exclusion List

    COVID-19 Booster Shots for Kids 5-11 Years of Age | 6/2/2022

    Codes and eligibility now available for COVID-19 booster shots for children ages 5-11

  • More pharmacy news

  • Dental

    Use “Premera Dental” as the Payer When Using Availity | 7/7/2022

    Learn some handy tips for using Availity’s secure provider website

    Availity Tips for Dental Providers | 2/3/2022

    Learn some handy tips for using Availity’s secure provider website

    Premera Transitions to Availity Secure Portal | 11/18/2021

    Dental providers can now access Availity to check eligibility and benefits and more for Premera members.

    Reimbursement Changing from Preparation Date to Seat Date | 9/16/2021

    Premera/LifeWise is changing payments for certain dental services

  • More dental news

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