Behavioral Health Provider Resources

Only the clinician providing the services can bill us. The clinician providing the services must be cited as both the rendering and servicing provider. Providers must be credentialed with Premera prior to seeing our members. Premera doesn’t credential associate level providers.

Premera can’t advise providers on billing and coding. You can consult with other providers in your community or talk to a behavioral health medical billing specialist.

• 2019 Professional CPT Code Book
• Washington Council for Behavioral Health
• Washington State Health Care Authority

If you have questions about claims, use our secure claims and payments tool (under Tools in the navigation).

Sign in and view our telehealth/telemedicine services payment policy. 

You can submit your claims to Premera electronically by signing up with Office Ally, a free full-service clearinghouse. Refer to our provider reference manual for more details on claim submission and payment.

No, Premera doesn’t credential or contract with associate level counselors.

You’ll find all the credentialing forms and information you need on the Join our Network page. Note: Behavioral health facilities wanting to join our network of providers need to complete an organization/facility credentialing/recredentialing application and W-9 . Email completed documents to provider.relationswest@premera.com.

Re-credentialing process
Providers must complete a re-credentialing packet every 3 years. If this isn’t submitted in a timely manner, it puts the contract at risk for termination. See previous information about our credentialing process.

You’ll receive a letter as soon as your application is approved. Your acceptance is based on complete application information and network requirements. The credentialing process may take up to 90 days to complete.

Note: Only contact us for a contract or credentialing status if it has been over 90 days from the date you submitted your complete credentialing application through ProviderSource. After 90 days you can email Physician and Provider Relations at provider.relationswest@premera.com.

If your submitted application is complete and you're accepted, you'll receive a contract to review and sign. After we receive your signed contract, we’ll send you a counter-signed contract and start date. For all Premera plans, you can't see members under the contract until you're officially credentialed.

It’s important that your patients (and potential new patients) know how to find you. If you have any changes to your practice, you can email us at provider.relationswest@premera.com or fax us a completed provider update form.

Email provider.relationswest@premera.com to verify the provider’s credentialing status with Premera.

• If the provider is already credentialed with Premera, you may submit a provider update form requesting to add the provider to your contract.
• If the provider isn’t credentialed with Premera, view the Join Our Network page to see how to submit credentialing documents.

Premera (or a vendor on Premera’s behalf) may request medical records for HEDIS^® or commercial risk adjustment purposes. As a contracted provider, you’re responsible for providing these records to Premera in a timely manner.