Provider News

  • Policy updates


  • Online tools

    Making Healthcare Work Better | 8/17/2017

    Updated Eligibility and Benefits Tool and New Code-Check Feature.
    Clinician Overview

    Clinician Overview | 6/15/2017

    Online learning helps newly-hired clinicians learn about Premera and insurance, in about 10 minutes.

    Eligibility and Benefits Improvements | 6/1/2017

    See renewal information and easily find the patient’s primary care provider.

    Improve Our Provider Website | 5/18/2017

    Try our easy card sort activity.

    Changes to Prospective Review Web Page | 5/18/2017

    Prospective review will be called prior authorization, plus new locations for links.

    Check for Claim Edits | 5/4/2017

    Use Premera’s Claims Editor-What If tool to test claims before submittal.
  • Medicare Advantage

    Enhanced Annual Wellness Visits | 7/20/2017

    Enhanced annual wellness visits help your patients with chronic conditions and are a yearly benefit.

    In-Home Fecal Immunology Testing | 7/20/2017

    Learn about our at-home testing program, now available to Medicare Advantage members.
    In-Home Health Assessments

    In-Home Health Assessments | 6/15/2017

    Premera is partnering with Matrix to offer in-home comprehensive health assessments for Medicare Advantage members.

    New Claims Editing System | 6/15/2017

    Edits on your Medicare Advantage claims may look different, and the Claim Connection tool will be down for a few weeks during the transition.
  • Company updates

    Digital ID Card | 7/20/2017

    Premera customers can now access their ID card on their phone, by email, and more.

    Managing High Cost Prescriptions | 7/6/2017

    Kits and combination packs can inflate costs of medication by as much as 2000%.

    New Maternity App for Expecting Mothers | 7/6/2017

    Integrated app enables early identification and intervention.

    Update on Quartet, a Behavioral Health Resource | 7/6/2017

    For primary care practitioners: Learn about a new resource for finding behavioral health providers and coordinating care.

    Advanced Imaging Reconsideration | 6/1/2017

    In late June, providers will have 10 calendar days to request advanced imaging reconsideration through AIM, Premera’s partner.

    Changes to Imaging Retrospective Review | 6/1/2017

    Learn about a new and faster process for submitting imaging claims for retrospective review.
  • Reminders and resources

    Update for Chiropractors and Massage Therapists | 7/20/2017

    Learn about the change in codes for non-medically necessary services.

    Outpatient Cost-Sharing | 7/20/2017

    Providers may collect outpatient cost-sharing at the time of service.

    Billing Unlisted Codes | 7/20/2017

    Avoid denials by supplying documentation to support any unlisted or miscellaneous code billed.

    New HCPCS Code for Kyleena | 7/20/2017

    Know the correct code for the contraceptive device, effective July 1, 2017.
  • Quality programs

    Chlamydia Screening in Women | 7/20/2017

    Learn how to improve care and close care gaps, while meeting a challenging quality measure.

    New Member Engagement Program | 6/1/2017

    Learn how Premera engages your patients to receive timely care.

    Out-of-area Medical Records Requests | 3/2/2017

    Find out more about medical records requests from other BCBSA plans.

    Access to Practitioners | 3/2/2017

    Learn about our annual research on practitioner appointment accessibility and our related policy.
  • Pharmacy

    Brand-Name Contraceptives | 8/17/2017

    The pharmacy formulary exception request form now includes a section for brand-name contraceptives.

    Pharmacy Prior Authorization Edit Expansion Program | 7/6/2017

    View the latest drugs and their related policies for our prior auth program.

    Epinephrine Pen Generics – Patient Education | 6/1/2017

    Use these flyers to help your patients learn about identical, lower-cost options.

    New Formulary Search Tool | 4/6/2017

    Quickly find reliable and current drug coverage and restriction information.
  • Dental

    Sleep Apnea Billing | 8/17/2017

    Learn key information about submitting claims for oral appliances.

    Dental Fee Schedules | 5/18/2017

    Learn how, when, and why we review dental fee schedules.

    Dental Claims Processing Change | 4/6/2017

    See details about the change to provider liability for certain dental claims.
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