Behavioral Health Provider Resources

Yes. The associate must be billed as the rendering provider.

The network status is determined by the billing provider’s tax ID number.

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.

• Washington Council for Behavioral Health
• Washington State Health Care Authority
• Check the latest Professional CPT Code Book

If you need information about claims, sign in to Availity.

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.

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.

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.

Premera doesn’t credential associate level providers, so they can’t hold a contract with Premera. However, claims can be billed for them as a rendering provider.

Yes. Once their full license is active, an application must be attested on OneHealthPort. Please notify credentialing that the application is available by sending an email to credentialing.updates@premera.com. 

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.

Send us an email 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.

Associate providers are added upon claims receipt, or you can submit a request by email to provider.relationswest@premera.com. When submitting your request via email, you can include a completed provider update form.

If you’re a contracted provider who moves out of our Washington and Alaska service areas, please be aware that your contract will terminate, and you’ll no longer be considered an in-network provider. This is the case even if you’re simply offering telehealth services to our Washington/Alaska Premera members.

However, we may be able to work with you if you contract with the local Blue Cross Blue Shield plan in your new state. You’ll need to check with your local Blue plans as they vary from state to state for contracting and coordination of Premera benefits.

If you’re planning to move out of our service area and you have questions about your contract or network status, send us an email.

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.

Use this sample template for the confidential exchange of information between medical and behavioral health providers.