Provider News

Everything You Need to Know About Your Explanation of Payment | 2/2/2023

The Explanation of Payment (EOP) gives you information about the adjudication of your claims

Tool for Documenting Diabetic Retinal Eye Exam Results | 2/2/2023

Assist your patients in getting their diabetic retinal eye exam results

Latest Update to Availity Provider Feedback | 1/5/2023

Our responses to your feedback from customer service calls, provider support teams, and Availity's online feedback feature

2023 ID Card Guide | 1/5/2023

Check out the newly updated 2023 Premera ID card guide

Premera Teams Respond to Availity Provider Feedback | 11/3/2022

Our responses  to your feedback from customer service calls, provider support teams, and Availity's online feedback feature

Provider Workshop: Premera HMO Core Plus | 10/6/2022

A training on the Premera HMO Core Plus plan product is December 7^th -  save the date

Encourage Medicare Advantage Patients to Get Screened for Colorectal Cancer | 3/2/2023

Tips for what information to include in medical records, codes for patient claims, and tips for talking with patients

Understanding Star Ratings - How are CMS star ratings determined? | 3/2/2023

Understanding Star Ratings - How are CMS star ratings determined?

Updates for Medicare Advantage Policies and Codes | 3/2/2023

The Medicare Advantage policies and code list have been updated

Medicare Advantage Members’ Annual Wellness Exams | 2/2/2023

These visits play an important role in helping your patients maintain or improve their health through disease prevention and detection

Updated Individual Plan Tools and Resources Page | 5/5/2022

We recently added news forms to the Individual Plan Tools and Resources page

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.

Rural Healthcare Brings Challenges and Rewards | 1/5/2023

Premera is working with the University of Washington to address the urgent need to improve access and health outcomes for rural populations by developing a pipeline of primary care in rural Washington state

Supporting Providers in the Health Equity Journey to Improve Patients’ Lives | 10/6/2022

Premera is working to reduce disparities in health and its determinants that adversely affect excluded or marginalized groups

Premera Invests $3 Million to Bridge Gaps in Mental Health and Health Equity Access | 9/1/2022

Premera announced $3 million in grants and sponsorships to 20 organizations across Washington and Alaska

New Premera HMO Plan | 9/1/2022

Our HMO plan will provide services to members in Pierce, Thurston, and Spokane counties

Premera Perspectives: Satya Sarma, Vice President of Medical Management and Population Health | 5/5/2022

Learn about Premera’s newest leader and her role to identify ways to address the needs of specific communities

Premera Invests $1.8 Million to Help Washington Colleges Address Critical Nursing Shortage | 5/5/2022

Grant establishes a new academic pathway to increase opportunities and remove barriers

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.

AIM Specialty Health Transitioned to Carelon | 3/2/2023

AIM Specialty Health changed its name to Carelon Medical Benefits Management on March 1, 2023

How To Submit Admission Notification | 3/2/2023

Inpatient admission notification helps in getting your claims paid correctly and on time

Keep Your Provider Data Current | 3/2/2023

Information to help you ensure you’re meeting federal requirements for provider data

AIM Specialty Health Transitions to Carelon | 2/2/2023

AIM Specialty Health will have a new name, Carelon, on March 1, 2023

Advanced Illness and Frailty Exclusions Allowed for HEDIS® Star Measures | 3/2/2023

Some patients can be excluded from select HEDIS^® star quality measures due to advanced illness and frailty – learn the criteria and codes

Helping Patients Who Use the Emergency Department for Migraines | 3/2/2023

Learn about informative migraine materials you can share with your patients

Outreach Mailings to Members with Children | 2/2/2023

Premera is reaching out to members to keep children on track with vaccines and checkups

High Blood Pressure Educational Mailing | 12/1/2022

Premera is providing members with winning tips for a healthy heart

Kroger is In-network for Premera Medical Advantage Plans | 2/2/2023

Premera Medicare Advantage plans use CVS pharmacy as the pharmacy benefit manager

Kroger- Express Scripts Termination Reminder | 1/5/2023

We encourage members to sign in to the Premera member portal to find other local, in-network pharmacy options

Kroger Removal from Express Scripts Standard Networks | 11/3/2022

Learn about impacted pharmacies and how it may affect your patients

2023 Essential Drug Exclusion List | 11/3/2022

Starting January 1, 2023, some drugs will change to preferred status, and some have been added to the Essential Drug Exclusion List

Use “Premera Dental” as the Payer When Using Availity | 7/7/2022

Learn some handy tips for using Availity’s secure provider website

Submitting Medicare Advantage Dental Claims for Out-of-Network Providers | 5/5/2022

Make sure your claims are going to the right place for processing

Visit our Medicare Advantage Dental Website | 4/1/2022

Resources to help you care for our Medicare Advantage members

Have You Opted Out of Medicare? | 2/25/2022

Information about providing care to Premera Medicare Advantage members

Availity Tips for Dental Providers | 2/1/2022

Learn some handy tips for using Availity’s secure provider website

Use Availity to Submit Premera HMO Referrals | 3/2/2023

Learn about the fastest way to submit referrals

Want to learn more about Premera HMO Core Plus? | 3/1/2023

The HMO provider resources page has more information and resources about the plan

Premera Answers Top Questions about HMO Core Plus Plan | 2/2/2023

Read the latest FAQ for Premera HMO

Premera Blue Cross HMO Core Plus Plan – Availity Trainings Now Available | 12/1/2022

Sign up for Availity webinar trainings today

Provider Workshop: Learn About Premera HMO Core Plus | 11/3/2022

We'll share Premera HMO Core Plus resources, plans details, and tips at the Provider Workshop