To see if prior authorization or pre-service review is required, sign in to our prior authorization tool for member-specific information.
For general code information, use our code check tool.
You can enter a medical or dental service code.
Note: This tool does not include nonspecific or unlisted codes (general codes that do not describe specific services) unless they are associated with a specific medical policy. We review all nonspecific and unlisted codes when the claim is submitted, regardless of whether they relate to a medical policy. The code check tool is not a guarantee of coverage as member contracts may differ in benefits.
The Federal Employee Program (FEP) has a separate code list and review requirements. View FEP prior authorization details.
Please make sure you're entering a valid, 5-character code. The code check tool does not accept modifiers.
Premera providersSubmit a request using our
prior authorization tool. Learn more about
submitting prior authorization, check out the
code list, or view our
tool guide for helpful tips.
Providers outside of Washington and AlaskaSign in to your local Blue plan's website for tools for out-of-area members. You'll be routed to our prior authorization tool to submit a request and attach records. You can also use our
pre-service review request form or view our
medical policies for coverage criteria.
For the best online experience with AIM and eviCore, start by signing in to the Blue plan’s website in your service area to find tools for out-of-area members. You’ll be routed to their website where you can submit authorizations for Premera members.
Dental providers:Please submit
dental pre-determination requests as you would normally submit a claim, by
electronic data interchange (EDI), or by mail to:
Dental ReviewP.O. Box 91059
Seattle, WA 98111-9159