Provider News

  • Policy updates


  • Online tools

    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.

    Electronic Funds Transfer | 5/4/2017

    Learn how to enroll, change your bank information, and more.
  • Medicare Advantage

    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.

    In-Home Bone Density Screenings | 5/18/2017

    MedXM will provide in-home bone density screenings for Medicare Advantage members.

    Medicare Enrollment Validation | 5/4/2017

    Revalidate your application when reminded by CMS.
  • Company updates

    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.

    ACA Possible Changes: Premera’s View | 5/18/2017

    Lean about Premera’s perspective on possible changes to the Affordable Care Act.

    Code Modifier for Habilitative Services | 5/4/2017

    Use the HCPCS modifier SZ when billing habilitative services.

    Phone Audit by Pacific Market Research | 4/20/2017

    You may receive a call from Pacific Market Research to verify your provider directory information.
    Helping Patients with Chronic Conditions

    Helping Patients with Chronic Conditions | 3/6/2017

    Landmark Health and providers collaborate to reach patients with multiple health conditions.
  • Reminders and resources

    Sign-Up for Email | 6/15/2017

    Don’t miss out—get Provider News delivered right to your inbox!

    Change to Ophthalmology Payment Policy | 6/15/2017

    Premera is changing the reduction percentage for multiple diagnostic ophthalmology procedures.
    Partnering with Premera

    Partnering with Premera | 6/15/2017

    See key updates for contracted providers.

    Cancer Coding and Documentation | 6/1/2017

    Find answers to your questions about coding and documenting breast, cervical, and colorectal cancer.
  • Quality programs

    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.

    HEDIS Requests Begin in February | 2/1/2017

    Verscend requesting HEDIS data for Premera customers.
  • Pharmacy

    Pharmacy Prior Authorization Edit Expansion Program | 6/1/2017

    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.
    New Epinephrine Pen Options

    New Epinephrine Pen Options | 4/6/2017

    Plan now for EpiPen refills.
  • Dental

    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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