Provider News

  • New approach to reduce E&M billing errors

    Coding Advisor aims to educate and reduce evaluation and management billing errors.

    Learn more

  • Policy updates

    News

  • Online tools and resources

    Prior Authorization Tool Tips and Updates | 7/16/2020

    Premera’s prior auth tool can save time and phone calls.

    Provider Workshop: Prior Authorization Tool | 7/16/2020

    Join us for a virtual training on the prior authorization tool.

    Availity Access to Premera Member Info for Out-of-Area Providers | 6/18/2020

    Learn about the multi-payer secure platform that launched on June 15.
    Join Our Network

    Join Our Network | 5/21/2020

    Resources and tips for completing credentialing applications.

    Online Tools Available to Check Claims and Eligibility | 4/16/2020

    Save time (and a phone call) using our online tools.
    Online Coding Resources

    Online Coding Resources | 3/13/2020

    Online tutorials and user guide help improve coding.
  • More online tools and resources news

  • Medicare Advantage

    New Medicare Advantage Medical Policy Update | 7/16/2020

    Check out the latest Medicare Advantage policies and prior auth list.

    HEDIS Measure: Medication Reconciliation Post-Discharge | 7/2/2020

    Get 3 helpful hints for patient medication reconciliation.

    A New Medicare Advantage Medical Policy Update | 6/4/2020

    Check out the MA policies and prior auth list.

    Payment Reduction for Medicare Advantage Claims Suspended | 5/21/2020

    Providing support and relief for US healthcare during COVID-19.
  • More Medicare Advantage news

  • Individual plans

    You Asked, We Listened: Individual Plans Resource Page!

    You Asked, We Listened: Individual Plans Resource Page! | 6/4/2020

    Get everything you need in one resource for Premera individual plans.
    View Individual Plan Deductibles, Benefits, and PCPs

    View Individual Plan Deductibles, Benefits, and PCPs | 3/19/2020

    Get tips for the Search Member Eligibility function.

    Incorrect Prefixes Printed for 2020 Individual Plans | 3/19/2020

    Get correct prefixes here.
    Individual Plans No Longer Using eviCore Healthcare

    Individual Plans No Longer Using eviCore Healthcare | 3/19/2020

    Learn how to submit a prior authorization for outpatient rehabilitation services. 

  • More individual plan news

  • Company updates

    New Approach to Reduce E&M Billing Errors

    New Approach to Reduce E&M Billing Errors | 7/16/2020

    Coding Advisor aims to educate and reduce evaluation and management (E&M) billing errors.

    Itemized Bill Review of Facility Claims | 7/2/2020

    Starting August 1, 2020, CERiS will perform itemized bill reviews of facility claims.

    Racism Is a Healthcare Issue | 6/18/2020

    We need to do Better.
    InterQual Criteria Used to Review Services

    InterQual Criteria Used to Review Services | 6/18/2020

    Premera expands use of InterQual® criteria to review services.

    Antibody Testing Medical Policy | 6/4/2020

    Premera’s Antibody policy is consistent with CDC’s guidance.

    Extended Prior Authorization Timelines Ending | 6/4/2020

    The timelines established by the OIC have ended.
  • More company updates news

  • High-value care

  • More high-value care news

  • Reminders and updates

    New Payment Policy: Personal Protective Equipment | 7/16/2020

    Personal Protective Equipment (PPE) will no longer be reimbursed.

    Reviewing HCPCS C Codes for Medical Necessity | 7/16/2020

    Premera will be reviewing HCPCS codes in the “C” series for medical necessity.
    Save Time by Using the Correct Forms

    Save Time by Using the Correct Forms | 7/2/2020

    Find out which 3 forms are the most commonly misused.

    Policy Update for Antibody (Serology) Testing | 6/18/2020

    Learn more about Premera’s benefit coverage guidelines.
  • More reminders and updates news

  • Quality programs

    Home Test Kits During COVID-19 Pandemic | 7/2/2020

    Members can complete important health tests at home.

    New Process for Payment Integrity | 6/18/2020

    Premera is working with MedReview and Claris Health for payment accuracy and appropriateness.

    Claims Coding Can Improve HEDIS Scores | 6/18/2020

    Learn how CPT® Category II and Z codes can reduce medical record reviews.

    HEDIS Quality Measure: Diabetes Care | 6/4/2020

    Improve patient health and reduce need for medical record reviews.
  • More quality programs news

  • Pharmacy

    Voluntary Recall for Metformin Hydrochloride Extended-Release Tablets | 7/2/2020

    Find out about FDA recall by Apotex Corporation for metformin hydrochloride ER 500 mg tablets.

    New Pharmacy Prior Authorizations and Edits on August 1, 2020 | 6/18/2020

    Learn which asthma and diabetes drugs will require prior authorization.

    New to Preventive Services: PrEP for HIV | 6/4/2020

    Starting July 1, pre-exposure prophylaxis (PrEP) will be covered as a preventive service.

    New Opioid Attestation Form Required for Prior Authorization Approval | 5/21/2020

    What you need to know about the new state opioid policy.
  • More pharmacy news

  • Dental

    Premera Will Not Cover the Added Cost of PPE | 6/4/2020

    Premera will not cover the added cost of the PPE on dental claims.

    Ensure Fast Processing for Dental Claims | 5/21/2020

    Include plan prefix on dental claim forms.
  • More dental news

  • Not finding what you're looking for here? Search our news archive.