The individual plan website is managed by Evolent Health for Premera and uses tools specifically for patients with individual plans. If a member has an individual plan, their ID card will say Individual Plan.View a sample member ID card.
View prefix list for Individual Plans.
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Note: Google Chrome is the best browser to use for the individual plan website.
A form isn't needed for sending us refund (overpayment) checks. You can submit requests in writing and include the following related to the overpayment:
If you received the message, "You have successfully logged into the Evolent application, but we do not find the Provider," read these instructions to provide key services to your individual plan patients.
The member eligibility search doesn’t accept member prefixes. Search by member ID or by the member’s last name and date of birth for accurate results.
The online claims submission tool for HCFA (CMS) 1500 claims currently isn’t available on the individual secure website. In the meantime, submit claims by mail to the address below or through Office Ally.
For professional and institutional claims, the claim payer ID is 00430 and for dental claims the ID is 47570.
Check out our COVID-19 FAQ for the lasted updates on prior authorization.
Use the following provider training guides to learn more about our individual plan tools:
Search for medical providers, facilities, and other specialists within the Premera Blue Cross Individual Signature network.
Find pediatric dental providers in the Dental Select network.
Individual plan forms:
Visit our forms page for all other provider documents.
Review our individual plan policies on our policy page.
Individual plans have a specific code list and InterQual criteria when reviewing certain services.
Learn about our programs that help members navigate the healthcare system and manage their health.
Call customer service at 800-607-0546 between 8 a.m. and 6 p.m., Monday through Friday, Pacific Time. Customer service can also provide web support and information on member eligibility and benefits.
Individual plan claims, appeals, and other paper correspondence must be sent to:
Premera Blue Cross PO Box 21702 Eagan, MN 55121
Call 844-966-0329 or fax 888-302-9325 to contact our utilization management team. Use this fax number to submit a prior authorization request.
InstaMed delivers all electronic funds transfer (EFT) payments and electronic remittance advice (ERA) for individual plans. If you submit and receive EFT/ERA through a clearing house, the clearing house needs to sign up for InstaMed.
Great! You’ll automatically receive EFT payments for our 2020 individual plan claims
You have 2 simple ways to sign up:
Sign up for an email subscription to receive Premera provider news and policy updates.