Admission and Discharge Notification

  • Hospitals must notify Premera of all inpatient admissions and discharges. Most plans require prior authorization.

    Services requiring prior authorization

    • Inpatient: non-emergency, elective, or scheduled admissions, including behavioral health and residential
    • Skilled nursing facility
    • Acute rehabilitation
    • Inpatient hospice

    Admission notification policies and procedures

    • For emergent/urgent admissions, notify Premera within 48 hours.
    • For maternity patients, admission notification isn't required for the first 48 hours for a vaginal delivery or the first 96 hours for a Cesarean. Inpatient stays beyond these timeframes require admission notification.
    • Babies admitted to an NICU require admission notification.
    • Elective or scheduled procedure patients must complete the admission notification process prior to being admitted.
    • Some patient admission situations make it impossible for providers to get prior authorization or notify us within the specified time period. Learn more in our extenuating circumstances policy.

    How to submit your admission notification