Premera Blue Cross and Soundpath Health

  • Medicare Advantage Plan Updates

    Premera Blue Cross received approval to acquire Catholic Health Initiative’s Soundpath Health Medicare Advantage (MA) contract, effective January 1, 2019. Soundpath Health currently serves more than 22,000 customers in Washington state.

    Soundpath Health customers will continue to receive their current benefits through the end of 2018. Premera and Soundpath Health will work closely with the Centers for Medicare & Medicaid Services (CMS) to ensure all seniors who receive benefits through Soundpath Health are properly notified and aware of their plan choices for 2019.

    Catholic Health Initiative also operates Medicare Advantage plans in Arkansas, Kentucky, Nebraska, and Ohio that are supported by staff in Washington.

    Check back periodically as this page will be updated as more information is available.

    Updated: December 13, 2018

    Frequently asked questions (FAQ)

    About the acquisition

  • Premera has purchased Soundpath Health’s Medicare Advantage contract (H9302), which serves more than 22,000 Medicare-eligible customers in Washington state. Premera is not acquiring any physical assets of Soundpath Health.

    You’ll continue to contact Soundpath Health for any benefit or eligibility questions through the end of 2018. Call the number on the back of the member’s Soundpath ID card. Starting January 1, 2019, if the member decided to remain on their Soundpath plan, you’ll contact Premera by calling the number on the back of the member’s new Premera ID card.
    Note: The Soundpath ID card won’t be valid after December 31, 2018.

    Yes, the 2019 MA plans will all have the same alpha prefix, ZNP, and Premera branding. Premera’s MA members use an ID card that includes the Blue Cross logo and clearly states Medicare Advantage. You can call Premera at the number on the back of the member’s ID card for information regarding any Premera MA member. View the ID card image and the names of all 9 MA plans.

    Soundpath Health’s contact information will remain the same through December 31, 2018. Check with Soundpath Health for any future changes.

    You’ll continue to send claims for dates of service on or before December 31, 2018 to Soundpath Health for processing. For dates of service after January 1, 2019, send claims to Premera. You’ll find the address on the back of the member’s Premera ID card.

    You’ll need to be contracted and credentialed with Premera to see Premera MA members. Visit Premera’s website to begin the process. You’ll need to allow 60 days for credentialing.

    You can continue to see your Soundpath Health patients through December 31, 2018. For dates of service on or after Jan. 1, 2019, you’ll need to be contracted and credentialed through Premera to see your Soundpath Health patients enrolled in one of Premera’s MA plans.

    You’ll continue to notify Soundpath Health of any demographic or contract changes through December 31, 2018. If you contract and credential with Premera, you’ll also need to notify Premera of any changes. If you have questions not answered here, contact your Premera Provider Network Executive or Provider Network Associate.

  • Transitioning patient care from Soundpath to Premera

  • Soundpath Health will continue to manage care for their members through the end of 2018. All prior authorization requests and claim payments for 2018 go through Soundpath.

    On January 1, 2019, Soundpath patients who transition to Premera will have a new Premera MA ID card. Ask for their ID card and update their information in your system at their first visit in 2019, in addition to any other steps you normally take when a patient changes their coverage.

    Yes. Primary care providers are required to manage referrals for their Premera patients and referrals are required for most services even if the provider is in the Premera MA network. This applies to all Premera MA plans. Referrals for members new to Premera’s MA plan in 2019 (including former Soundpath members) can be submitted now by following our normal process and submitting them through our website or faxing a referral form.

    Prior authorizations approved by Soundpath in 2018 that span into 2019 for Soundpath members who stay on a Premera plan will remain in place. We’ll transfer these prior authorizations into our system. You won’t need to submit a new request. For new or expired authorizations in 2019, you’ll need to follow the normal process by submitting your request online or by completing and faxing a prior authorization request form. These new requests can be submitted to Premera now.

    On January 1, 2019, Premera will begin managing all skilled nursing facility admissions. This includes members who entered a skilled nursing facility in 2018 and have a continued stay into 2019. For ongoing authorization requests, fill out a Premera Medicare Advantage rehabilitation form request. For these admissions, submit claims to Premera.

    Members admitted to acute care facilities in 2018 with a continued stay into 2019 will be managed by Soundpath until the member discharges. Submit your continuing authorization request to Soundpath. Submit claims for these admissions to Soundpath.

    If you have questions not answered here, contact your Premera Provider Network Executive.