Provider News

  • Enhanced Edits Based on Provider Specialty

    Provider’s specialty and tax identification number will be used to determine application of edits.

    Learn more

  • Policy updates

    News

  • Online tools and resources

    Provider Workshop featuring Lee McGrath, Executive Vice President of Health Care Services | 1/7/2022

    On Wednesday, January 19, Lee McGrath will be sharing her vision for Premera in 2022 and beyond.
    2022 ID Card Guide

    2022 ID Card Guide | 1/6/2022

    The 2022 ID card guide is now available

    Availity Updates: Remittance Viewer and Plan Availability | 12/16/2021

    Get tips on remittance viewer and plans served through Availity.

    Premera Transitions to Availity Secure Portal | 11/18/2021

    Premera Transitions to Availity Secure Provider Portal

    Provider Workshop: Credentialing | 10/7/2021

    On Wednesday, November 10 at 1:30 p.m., our provider relations team is hosting a workshop focused on credentialing

    Provider Workshop: Claims and Claims Editing

    Provider Workshop: Claims and Claims Editing | 9/16/2021

    Overview from the September 15 workshop
  • More online tools and resources news

  • Medicare Advantage

    Medicare Advantage Medical Policies | 1/6/2022

    Learn about newest updates for MA policies.

    Premera Medicare Advantage 2022 Plan Resources | 12/16/2021

    Learn where to find Medicare Advantage online tools, forms, policies, and the prior authorization list.

    Dental Benefit Changes for Medicare Advantage 2022 Plans | 12/16/2021

    Dental Benefit Changes for Medicare Advantage 2022 Plans

    New Medical Policies - Medicare Advantage | 12/2/2021

    Learn about newest updates for MA polices
  • More Medicare Advantage news

  • Individual plans

    Changes for 2022 Individual Plans | 9/16/2021

    Premera Blue Cross will no longer be offering individual plans in Skamania and Wahkiakum counties

    Everything You Need to Know About 2021 Individual Plans | 1/7/2021

    See resources and training guides for 2021 Individual plans.
  • More individual plan news

  • Company updates

    Premera Deepens Connection to Communities with County By County Giving Initiative | 12/2/2021

    Grants awarded in every county and borough throughout Washington and Alaska

    Enhanced Claims Editing Implementation | 11/18/2021

    Enhanced claims editing applied to claims processed for payment.

    How YMCA Snohomish County Helped Families During Remote Learning | 11/4/2021

    Premera is proud to work with YMCA of Snohomish County to provide a safe and supportive environment for children in our community.
    Avoid Claim Edits and Denials with These Helpful Tips

    Avoid Claim Edits and Denials with These Helpful Tips | 9/2/2021

    Upcoming expansion of claim editing affects professional and facility claims

    Availity Premera Provider Portal Launch Coming Soon | 8/5/2021

    Premera will have a single-source solution for all our providers through Availity’s secure provider portal

    Facility Claim Editing Expansion | 7/1/2021

    Starting this fall, Premera is expanding facility claim editing
  • More company updates news

  • High-value care

    Value-Based Care and Premera Provider Relationships | 3/18/2021

    Relationships built on trust, shared data, and analytics can decrease cost of care and health outcomes.

    Payment Models Shift to Value-Based Care | 12/17/2020

    Healthcare organizations and health plans are shifting from care models built around fee-for-service reimbursement to value-based care.
  • More high-value care news

  • Reminders and updates

    New Code for Post COVID-19 Conditions | 1/6/2022

    This code is for conditions which are the consequence of COVID-19.

    Gender Affirming Treatment Law Now in Effect | 1/6/2022

    Starting January 1, 2022, transgender health care coverage will be extended in Washington.

    AIM Provider Portal Changes | 1/6/2022

    AIM provider portal allows users to see the order ID on all authorization requests.

    Enhanced Edits Based on Provider Specialty | 1/6/2022

    Provider’s specialty and tax identification number will be used to determine application of edits.
  • More reminders and updates news

  • Quality programs

    Outreach for Well Child Checkups Continues in December | 12/2/2021

    Well-child visits are crucial to children receiving timely care and vaccines

    Premera Programs Help Members Choose High Quality Providers | 11/18/2021

    Learn about our Centers of Excellence and Blue Distinction Specialty Care Programs

    Care Gap Member Outreach | 10/21/2021

    Member communications sent about cancer screenings, care for chronic conditions, and well-child checkups.

    Medical Records Requests | 10/21/2021

    This fall, your office may receive medical record requests from Change Healthcare and Cotiviti.
  • More quality programs news

  • Pharmacy

    Clinical Pharmacist will Conduct Medical Benefit Drug Reviews | 1/4/2022

    Starting January 1, Premera clinical pharmacists will be reviewing medical necessity for drugs requested through the medical benefit

    Changes to 2022 Essential Drug Exclusion List | 11/4/2021

    Find out about the changes to the Essential Drug Exclusion List

    Voluntary Recall for Glucagon ® Emergency Kit for Low Blood Sugar | 10/21/2021

    On September 26, Eli Lilly and Company voluntarily recalled Glucagon® Emergency Kit for Low Blood Sugar.

    Pfizer Voluntary Recall of Chantix Lots | 8/19/2021

    Patients have been advised to consult with their doctor to confirm if they received an affected lot
  • More pharmacy news

  • Dental

    Premera Transitions to Availity Secure Portal | 11/18/2021

    Dental providers can now access Availity to check eligibility and benefits and more for Premera members.

    Reimbursement Changing from Preparation Date to Seat Date | 9/16/2021

    Premera/LifeWise is changing payments for certain dental services

    Use Medical Codes and Forms to Expedite COVID-19 Vaccine Claims | 5/6/2021

    To get your claims paid more quickly, use COVID-19 vaccine medical codes

    New Payment Policy: Tele-dentistry Services | 3/18/2021

    Dental services are approved to be provided through tele-dentistry.

    New Medicare Advantage Dental Form and P.O. Box | 1/21/2021

    The form has easy-to-follow instructions and a new PO Box address for submitting claims.
  • More dental news

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