Join Our Network

  • Two important things to know before you get started

    1. Before you can request a contract, you need to be credentialed. To verify your credentialing status, make sure you're listed in our provider directory or email us. For faster processing, make sure your CAQH data is up to date.

    2. You can request an individual contract or join one of our contracted independent practice associations or medical groups. To establish a contract in Washington, you must provide care primarily in Washington state. You may be eligible if practicing in an adjacent county bordering Washington state. If you have questions, email us.

    New credentialing applicants

  • Apply for credentialing

    You can request an individual contract or join one of our contracted independent practice associations or medical groups after meeting our credentialing criteria and standards.

    We use the Council for Affordable Quality Healthcare (CAQH) for electronic credentialing applications. Complete your application by signing in to CAQH. Use our provider credentialing checklist to make sure you've submitted all necessary information.

    Note: You must reside in the state of Washington to be credentialed with Premera.

    Submit your application

    Once your CAQH application is complete, submit a credentialing request through our credentialing intake portal.

    You'll receive a confirmation email that says we've received your request. If you don't receive an automated response, please make sure you used the correct email address.

    Facility providers

    Please send us an email to request to contract with us. Be sure to include the following information for the facility:

    • Legal name
    • DBA name
    • Facility tax ID number
    • Facility specialty
    • Facility address

    We'll review your request and send you a facility intake form for credentialing if needed.

    Credentialing verification

    We work with a company called Certify for credentialing verification. They're certified by the National Committee for Quality Assurance (NCQA) as a credentialing verification organization to handle credentialing application verifications and ongoing monitoring. Certify may contact you on our behalf if additional information is needed during the credentialing process. This collaboration aims to streamline and make the credentialing process much faster for providers.

    How to avoid a delay

    The top reasons for incomplete applications include the following:

    • Premera not added as an authorized agency to access the CAQH application
    • CAQH application not complete and attested within 90 days
    • Missing SS-4 (EIN) on new contracts
    • Incomplete address, suite number, or phone number
    • Missing work history or education information
    • Hospital privileges, if applicable

  • Existing credentialed providers

  • Provider update - Email this form to Premera with new information or changes to your current practice or payment structure. The federal No Surprises Act requires health plans to verify all provider directory data every 90 days. It also requires all providers and facilities to submit this information to in-network plans. Unverified providers may be removed from our directory.

    To request a new contract, please email us the following information. Note that you must reside in Washington state to be credentialed with Premera.

    • Copy of the SS-4 or 147c letter from the IRS
    • DBA name
    • TIN
    • Address (location, remit/mail)
    • Phone number
    • Fax number
    • Email (for sending your contract through DocuSign)
    • Practitioner name(s) and NPI(s)
    • Name of the business owner(s)
    • Effective date

    Note: You must reside in the state of Washington to be credentialed with Premera.

    You'll receive an email confirmation from Premera that notes we've received your request. Credentialing typically takes less than two weeks. If it's a new contract, our team will respond within 45 to 60 business days to review, sign, and return all documents through DocuSign. If we don't receive the signed documents within 30 days from the date the contract is emailed to you, your request will be closed.

    Later, you'll receive a counter-signed copy with your contract effective date. The contract won't be effective until counter-signed by Premera.

    Request a copy of your contract

    If you need a copy of your contract, send us an email request that includes your contract name (full legal name as reported to the IRS), tax identification number (TIN), and your relationship to the provider. Once received, we’ll send your contract as an email attachment. Please note this email is only for requesting contract copies.

     

  • Premera provider resources and tools

    Learn more about the digital tools and resources that you'll have access to as a credentialed Premera provider.

  • Availity

    Premera uses Availity as its primary secure portal. Sign in to Availity or register for training. View our Availity provider FAQ for more details.

    Our learning center is a great resource for provider training and information, including the following:

    • Guides for using our individual plans
    • Provider workshop information and recordings
    • Continuing medical education resources for health equity
    • Network and ID card guides
    • Coding resources

    Check out the learning center today.

    It’s important to keep up with the latest Premera news and policy updates. Premera Provider News is the primary way we communicate with our contracted provider offices.

    Sign up for an email subscription today!

    Our contact us page gives you all the Premera contact information you need.