Provider News

  • Refund payment format updated

    Premera is reducing its carbon footprint and streamlining work.

    Learn more

  • Policy updates

    News

  • Online tools and resources

    Real-Time Estimator Tool Unavailable Starting April 16 | 4/15/2021

    Our real-time estimator tool will be down for maintenance starting on April 16

    Premera Learning Center Can Make Your Day Easier | 4/9/2021

    Online tools and trainings are fast ways to learn online
    Update Your Provider Directory Info

    Update Your Provider Directory Info | 4/1/2021

    Has your office information changed recently?

    Provider Workshop: Medicare Advantage | 4/1/2021

    Learn more about our Medicare Advantage tools and time-saving tips.

    Time-Saving Resources: Code Check and Prior Auth Tools | 2/18/2021

    Save time and a phone call with these two quick resources.
    Premera Contracts and DocuSign

    Premera Contracts and DocuSign | 2/4/2021

    As of February 1, 2021, all contracts will be sent via DocuSign.
  • More online tools and resources news

  • Medicare Advantage

    Medicare Advantage Medical Policies | 5/6/2021

    Medicare Advantage medical policy and PA code list updates are now available

    Expedited Prior Authorization Requests | 4/1/2021

    These requests should only be used when waiting for a standard review might jeopardize health of the patient.

    Medical Records Requests for Annual HEDIS® Review | 2/4/2021

    CIOX Health will contact provider offices for records starting in February.

    Updates for Medicare Advantage Medical Policies | 1/21/2021

    View MA medical policy updates and updated prior authorization code list.
  • More Medicare Advantage news

  • Individual plans

    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 Invests in Rural Health | 4/1/2021

    Premera granted $4.7 million to establish the Rural Nursing Health Initiative to place current students in rural practices in Washington state.

    Premera Team Reunites Member with Family | 3/18/2021

    Working with providers and medevac teams, Premera was able to help a member return to her family.

    Capital Grants for Rural Facilities | 3/18/2021

    Grants available to hospitals, outpatient clinics, and other healthcare providers in rural areas of Washington State.

    Premera Awards $850,000 to Organizations Working Toward Health Equity | 3/4/2021

    Premera Blue Cross announced grants made to three non-profit organizations focused on improving health equity in support of the Black community.
    COVID-19 Updates

    COVID-19 Updates | 1/21/2021

    Our FAQ is updated regularly with the most accurate information.

    Minding Mental and Heart Health | 1/20/2021

    Did you know 33%of people who’ve survived a heart attack will suffer from depression?
  • 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

    Credentialing TIN Requirement Update | 5/6/2021

    Send us your SS-4 letter instead of W-9
    Refund Payment Format Updated

    Refund Payment Format Updated | 5/6/2021

    Premera is reducing its carbon footprint and streamlining work

    Annual Risk Adjustment Data Validation Audits | 5/6/2021

    Offices may receive a request for medical records from Cognisight or Premera

    Transparency in Coverage Rule | 4/15/2021

    What is this new rule and what will Premera/LifeWise do to comply.
  • More reminders and updates news

  • Quality programs

    HEDIS Measure: Comprehensive Diabetes Care | 5/6/2021

    Improve patient outcomes while reducing medical records review requests

    Diagnosis Coding for Immuno-compromise | 5/6/2021

    A common error in coding is not considering whether the condition is caused by medication or by an underlying chronic condition

    HEDIS Measure: Controlling High Blood Pressure | 4/9/2021

    Blood pressure coding can reduce HEDIS®medical record requests

    Enhanced Care for Out-of-Area Blue Plan Members | 4/1/2021

    Premera is working with providers to increase care quality by making sure members can get appropriate care no matter where they are.
  • More quality programs news

  • Pharmacy

    What’s the Difference Between Cologuard and FIT Kits?

    What’s the Difference Between Cologuard and FIT Kits? | 3/4/2021

    We encourage you to support colon cancer prevention and keep cost information in mind when recommending at-home colon cancer screening.

    New Pharmacy Prior Authorizations Started in January | 1/21/2021

    Learn which drugs now require a new prior authorization.

    Insulin Cost-Sharing Cap Mandate | 12/3/2020

    New requirements start on January 1, 2021.
    New Pharmacy Prior Authorizations Required on January 1

    New Pharmacy Prior Authorizations Required on January 1 | 11/19/2020

    Some drugs will require a new prior authorization on January 1, 2021. Get the details.
  • More pharmacy news

  • Dental

    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.

    Answers to Common Dental Questions | 11/19/2020

    Frequently asked questions, helpful dental links, and more dental resources available in one place.

    Ensure Fast Processing for Dental Claims | 11/13/2020

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

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