Provider News

  • Updated individual plan tools and resources page

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

    Learn more

  • Policy updates


  • Online tools and resources

    Premera Prior Authorizations Moving to Availity | 5/5/2022

    New tool eliminates the need to fax. Find out what you need to know.

    Premera Prior Authorizations Moving to Availity Essentials | 4/8/2022

    You’ll soon be able to request prior authorizations through Availity

    Provider Workshop: Behavioral Health | 4/1/2022

    On Wednesday, May 11 at 1:30 p.m., we’re hosting a workshop focused on supporting Behavioral Health Providers

    Resources Available in the Provider Learning Center | 4/1/2022

    Premera Learning Center resources can make your day easier

    Provider Workshop Overview | 2/3/2022

    The January Provider Workshop to discussed some of the projects Premera will be doing in 2022

    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.
  • More online tools and resources news

  • Medicare Advantage

    Medicare Advantage - Medical Policies | 5/5/2022

    Learn about newest updates for Medicare Advantage polices

    Medicare Advantage Medical Policies April Update | 4/1/2022

    Learn about the newest updates for Medicare Advantage polices

    Enter Your Medicare Advantage Referral Requests with Our Online Tool | 2/24/2022

    Don’t forget your referral start and end date need to match

    Medicare Advantage Medical Policies Update | 2/24/2022

    Learn about newest updates for Medicare Advantage (MA) policies
  • More Medicare Advantage news

  • Individual plans

    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.
  • More individual plan news

  • Company updates

    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

    Fighting Substance Use Disorders with Medication-Assisted Treatment | 4/1/2022

    This is the first article in a series highlighting the importance of medication-assisted treatment and breaking down the stigma of substance use disorder

    Change To The Existing Hospital Bill Audit | 2/24/2022

    Medical records must be submitted within 90 days of the request

    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.
  • 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 Prefixes for Blue Cross Idaho Members | 4/1/2022

    Prefixes have been updated for certain Blue Cross Idaho members. Please ask your patients for updated ID cards

    Overpayment Recovery Update | 4/1/2022

    Effort for being made to reduce our carbon footprint by reducing mailing and streamline work for providers

    New Payment Policy: COVID-19 Testing | 4/1/2022

    Diagnostic testing, surveillance testing and over the counter tests reviewed

    Audio-only Telehealth Modifiers | 4/1/2022

    Audio-only services need to be identified by adding one of the new audio-only modifiers
  • More reminders and updates news

  • Quality programs

    Plan All-Cause Readmissions, a Revised HEDIS® Measure | 5/5/2022

    Revised measure focuses on preventing unnecessary hospital readmissions

    Care Gap Member Outreach | 5/5/2022

    Members will be receiving cancer screening, diabetes, asthma, and preventive care communications

    HEDIS Measure: Colorectal Cancer Screening | 2/25/2022

    Encourage eligible Medicare Advantage patients to get screened for colorectal cancer

    Advanced Illness and Frailty Exclusions Allowed for HEDIS® Star Measures | 2/25/2022

    Encourage eligible Medicare Advantage patients to get screened for colorectal cancer
  • More quality programs news

  • Pharmacy

    Walgreens Specialty Pharmacy Name Change | 5/5/2022

    New name, same patient-first service

    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.
  • More pharmacy news

  • Dental

    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

    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.
  • More dental news

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