Provider News

  • New UB-04 hospital claim validation edits

    Data elements/fields on hospital claims will be reviewed for validity and correct coding.

    Learn more

  • Policy updates

    News

  • Online tools and resources

    2020 ID Card Guide Available

    2020 ID Card Guide Available | 1/1/2020

    Learn about plans, new networks, copays, and view sample ID cards.

    New Feature: Comments for Electronic Claims | 1/1/2020

    Why should I comment on electronic claims?

    Helpful Tips for Coding Respiratory Diseases | 12/19/2019

    Our web-based training can help your office!

    Determining Member Eligibility and Coverage | 11/7/2019

    Did you know that plan benefits vary widely by contract? Find out how it works.
  • More online tools and resources news

  • Company updates

    New Claims Mailing Address for 2020 Individual Plans | 12/19/2019

    Tips for processing claims for 2020 Individual Plans.

    Appeal Process for 2020 Individual Plans | 12/19/2019

    Learn how to submit clinical and claim appeals and request peer-to-peer reviews.
    Everything You Need to Know About 2020 Individual Plans

    Everything You Need to Know About 2020 Individual Plans | 12/19/2019

    Resources, training guides, and more!

    New Secure Site for Premera 2020 Individual Health Plans | 12/19/2019

    Learn how to access and preview our 2020 Individual plan site in OneHealthPort.

    Prior Authorization Process Changing for Premera’s 2020 Individual Plans - Updated Information! | 12/12/2019

    Everything you need to know about 2020 prior authorizations.

    New Member ID Cards for 2020 Individual Plans | 12/5/2019

    How to identify an Individual plan member.
  • More company updates news

  • High-value care

    Blue Distinction Centers for Substance Use Treatment and Recovery | 12/5/2019

    Premera has 13 providers designated as Centers of Excellence in substance use treatment and recovery.

    Premera Offering Grand Rounds Expert Service to Customers | 2/21/2019

    What you need to know if a patient requests a second opinion from Grand Rounds.
    Looking for Specialty Care Referrals That Are High-Quality and Cost Efficient?

    Looking for Specialty Care Referrals That Are High-Quality and Cost Efficient? | 2/7/2019

    Premera’s Blue Distinction Specialty Care designations can help.

    Value-Based Specialty Care and Our Customers | 1/17/2019

    Together we can change the way customers choose specialty care providers.

    Value-Based Payment Models | 11/15/2018

    Learn more about the shift to a model that rewards high-quality, cost efficient care.
  • More high-value care news

  • Reminders and updates

    UB-04 Hospital Claim Validation Edits

    UB-04 Hospital Claim Validation Edits | 1/16/2020

    Data elements/fields on hospital claims will be reviewed for validity and correct coding.

    Cologuard’s DNA Test Versus Standard FIT Kits | 1/1/2020

    Learn why FIT Kits are just as effective for at-home colon cancer screening.

    Updates to Telehealth/Telemedicine Payment Policy | 1/1/2020

    Policy exceptions will be eliminated starting April 2020.

    Premera’s Diabetes Management Programs | 12/19/2019

    Learn how Premera is providing members with tools to self-manage their diabetes.
  • More reminders and updates news

  • Quality programs

    Knowing Where to Go: ER Alternatives | 1/16/2020

    Helping members be aware of emergency room alternatives.

    Medical Records Review: February 2020 | 1/1/2020

    Premera and COTIVITI will be reaching out for a HEDIS medical record review.

    Knowing Where to Go: ER Reduction Mailer | 11/21/2019

    Alternatives available to visiting the emergency room.
  • More quality programs news

  • Pharmacy

    Institute for Clinical and Economic Review: Our Pharmacy Watchdog | 1/16/2020

    How is Institute for Clinical and Economic Review (ICER) is helping health plans make decisions?

    Voluntary Recall on Ranitidine | 12/19/2019

    Another manufacturer has recalled Ranitidine Tablets and Ranitidine Syrup.

    National Shortage of IVIG and SCIG Drugs | 11/21/2019

    How we can work together to ensure customers get the drugs they need.

    2020 Essentials Drug Exclusion List Is Available | 11/21/2019

    What drugs are not covered for 2020?
  • More pharmacy news

  • Dental

    Connecting Dental and Healthcare | 11/21/2019

    Learn more about Premera approach to dental care.

    Resources Available for Dental Providers | 11/21/2019

    Need a refresher on the responsibilities and requirements for Premera dental providers?

    Reducing the Risk of Opioid Addiction | 11/21/2019

    Learn about our opioid policies to help prevent addiction.
    Expanding our Dental Network to Meet Member Needs

    Expanding our Dental Network to Meet Member Needs | 11/7/2019

    Premera and United Concordia Dental (UCD) will work together to meet the needs of our growing dental membership.
  • More dental news

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