Claims

  • How to get your doctor bills paid

    When you see an in-network doctor, dentist, or other healthcare provider, they will submit the bill to us. That's called a claim. You might also receive a bill from your provider, but wait to hear from us before paying it.

    1. We pay our portion to your healthcare provider. We'll pay according to your plan then send you an explanation of benefits (EOB) that explains the cost breakdown and how your claim was processed.
    2. Each time you visit a healthcare provider and file a claim, you receive an Explanation of Benefits (EOB), which explains how your claim, or the request for payment, was processed. 

    If you saw an out-of-network provider or paid up front for your care or prescriptions, you can submit a claim yourself.

    To file a claim

    1. Complete a claim form.
    2. Attach an itemized bill from the provider for the service.
    3. Make a copy for your records.
    4. Mail your claim to Premera Blue Cross, P.O. Box 91059, Seattle, WA 98111-9159.

    Go paperless

    Your EOBs are available in your online member account. If you'd like to skip the paper option (U.S. Mail), you can opt to go paperless.  

    Family member EOBs

    Family members 13 and older can create their own online accounts and can choose who can see all claims or only nonsensitive claims.

    The default setting is that the subscriber spouse or parent will see nonsensitive claims. Sensitive claims have to do with any diagnosis or procedure that's related to genetic information, chemical dependency, mental health, reproductive health, pregnancy, sexually transmitted diseases, HIV, and AIDS.

    To change your settings, sign into or create an online account and and look for Privacy Settings under Claims.