Contact Information, Confidentiality, and Appointment Access

  • Contacting us

     
    General Correspondence Alaska Mailing Address
    Premera Blue Cross Blue Shield of Alaska
    P.O. Box 91059
    Seattle, WA 98111-9159    		  
    Spokane Main Office
    3900 East Sprague Avenue
    Spokane, WA 99220-3048    		 Mailing Address
    Premera Blue Cross
    P. O. Box 3048
    Spokane, WA 992202-3048
    Mountlake Terrace
    (Seattle)    		 Premera Headquarters
    Premera Blue Cross
    7001 220th St SW
    Mountlake Terrace, WA 98043-2124    		 Mailing Address
    P.O. Box 327
    Seattle, WA 98111-0327
    Address for Submitting Claims Claims
    Premera Blue Cross Blue Shield of Alaska
    P.O. Box 91059
    Seattle, WA 98111-9159

    Federal Employee Program
    Member Claims:
    Premera Blue Cross Blue Shield of Alaska
    P.O. Box 33932
    Seattle, WA 98133-0932

    		  
    Calypso Overpayment Refunds
    (excludes NASCO)
    800-364-2991
    P.O. Box 327
    Mail Stop 229
    Seattle, WA 98111-0327    		 Subrogation Case Management
    888-704-0638
    P.O. Box 327
    Mail Stop 227
    Seattle, WA 98111-0327
    Electronic Claims
    (EDI)
    EDI@premera.com    		   800-435-2715
    Fax: 425-918-4234
    P.O. Box 327
    Mail Stop 281
    Seattle WA 98111-0327
    Interest-related Questions Prompt Pay
    800-932-2883    		  
    Care Management 800-722-4714, option 3
    Fax: 800-866-4198
    P.O. Box 327
    Mail Stop 453
    Seattle, WA 98111-0327    		  

  • BlueCard

    BlueCard Host

    BlueCard Eligibility Inquiries
    888-261-9562
    Fax: 425-918-4115

    800-676-BLUE (2583)
    P.O. Box 91059
    Seattle, WA 98111-9159

    NASCO

    National Account Service Company (NASCO)

    BlueCard Eligibility Inquiries
    800-713-5373
    Fax: 425-918-6986
    P.O. Box 91059
    Seattle, WA 98111-9159

  • Each contracted provider is assigned to a PNE or PNA at Premera. Call 877-342-5258, option 4 to speak with your PNE or PNA, who manages:

    • Hospital/facility contracting
    • Policies and procedures
    • Practitioner contracting
    • Network adequacy
    • Your interactions with Premera
    • Contract status inquiries

    PNRs quickly handle your requests and resolve non-claims issues. Email us at Provider.RelationsWest@Premera.com for:

    • Panel updates
    • Address changes
    • Tax ID number updates
    • Telephone number changes
    • Clinic opening or closing
    • Malpractice insurance changes
    • Directory copy requests
    • Additions to your clinic
    • Questions about OneHealthPort
    • Questions on a physician/provider mailing
    • Practitioner/dental retirement, etc.
    • Document copy requests (e.g., News Briefs, manuals, etc.)

    Call Premera Blue Cross at 800-508-4722.

  • Confidentiality policy

    Our confidentiality policy protects the confidentiality and privacy of our member's protected personal and medical information by preventing the unauthorized use and disclosure of such information by our associates and business associates.

  • Protected Personal Information is any and all information created or received by the company that identifies or can readily be associated with the identity of an individual, whether oral or recorded in any form or medium, that directly relates to the:

    • Past, present, or future physical, mental, or behavioral health or condition of an individual
    • Past, present, or future genetic information of the individual or their dependent, or relative of either
    • Past, present, or future payment for the provision of healthcare to an individual
    • Provision of healthcare to an individual
    • Past, present, or future finances of an individual, including, without limitation, an individual's name, address, telephone number, Social Security Number, subscriber number, or wage information

    We're committed to maintaining the confidentiality of individual's protected personal health and financial information (collectively referred to as “protected personal information” or PPI). Premera collects, uses, and discloses PPI solely for routine business functions or as required or permitted by law or regulation. We strictly prohibit the unauthorized disclosure of PPI by our associates and business associates, unless we have first obtained the member's written authorization.

    We understand that you value standards of confidentiality as a healthcare professional. As a contracted physician or provider, you're required to maintain the confidentiality of all PPI concerning any current or former patients (our members). In addition, you're also bound to observe certain state and federal privacy laws. At a minimum, each clinic should have each staff member sign a confidentiality statement upon employment in which the employee acknowledges the importance of maintaining the confidentiality of PPI. This is a Premera office site standard used in our credentialing and recredentialing process.

    The “authorization for treatment” that you obtain from Premera members prior to rendering services authorizes you to disclose general health information to us. The validity of such an “authorization for treatment” isn't limited to 90 days, and such disclosures don't need to be documented in the member's medical chart. State and federal privacy laws allow physicians and providers to disclose PPI to Premera without the patient's authorization for payment purposes and healthcare operations such as:

    • Determining eligibility
    • Utilization and medical/dental necessity reviews
    • Healthcare operations activities (e.g., case and care management, quality reviews)

    Any activity undertaken by the company, or by a business associate on behalf of the company, for healthcare operations and payment activities:

    • Carrying out the management functions of the company, examples include: underwriting, actuarial, care management, case management, and quality reviews
    • Obtaining subscription charges
    • Determining or fulfilling its responsibility for coverage under the health plan and for the provision of benefits under the health plan, examples include: member benefit eligibility, payment of member claims, and coordination of member benefits with other insurance carriers or liable third parties

  • Provider Appointment Accessibility Standards including After-Hours Care

    Surveys and data collection to assess our members’ access to providers are done annually. Our provider appointment accessibility standards are based on requirements of the National Committee for Quality Assurance (NCQA) Accreditation Program, Washington Administrative Code 284-170-200(13) and applicable federal law. NCQA accreditation is required in order to sell plans in the Washington Health Benefit Exchange.

    Below are the standards for member access to care that we measure in our monitoring.

    Access to Appointments: Primary Care Providers

    Appointment Type Standard
    Regular or routine care appointments Within 10 business days
    Physical exams, preventive care Within 30 business days
    Urgent care Within 48 hours
    After-hours care Providers must provide coverage for their practices 24 hours a day, 7 days a week, with a published after-hours phone number to a pager, answering service, or recorded message directing members to a physician for after-hours care.

    Access to Appointments: Specialty Care Providers

    Appointment Type Standard
    Regular or routine care appointments Within 15 business days
    Urgent care appointments Within 48 hours
    After-hours care Providers must provide coverage for their practices 24 hours a day, 7 days a week, with a published after-hours phone number to a pager, answering service, or recorded message directing members to a physician for after-hours care.

    Access to Appointments: Behavioral Health Providers

    Appointment Type Standard
    Behavioral health: Regular or routine care Within 10 business days
    Behavioral health: Urgent care Within 48 hours
    Behavioral health: Care for a non-life- threatening emergency Within six hours
    After-hours care Providers must provide coverage for their practices 24 hours a day, 7 days a week, with a published after-hours phone number to a pager, answering service, or recorded message directing members to a physician for after-hours care.