July 1, 2021
Starting on October 1, 2021, Premera will implement enhancements to our prepayment professional and facility claim editing processes to promote additional correct coding and billing practices. The implementation will include coding validation services
provided by registered nurses and certified coders to review claims for correct coding in addition to the current automated claim editing systems.
These enhancements take into consideration Premera’s historical claims experience, as well as policy guidelines from the following sources:
Premera’s payment policies will continue to be enforced along with the enhanced editing such as:
Additional details will be published in a future article before enhanced editing begins.
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