November 16, 2017
If you're not part of Premera's Personal Care Partner Systems Network, you'll want to know the following information before seeing or referring PersonalCare Plan patients for services.
About PersonalCare Plans
Premera PersonalCare Plans are referral-based plans that promote an engaged relationship between patient and provider. Primary care providers (PCPs) within each Partner System coordinate care with specialists to streamline the patient's experience and make sure they only receive needed tests and care. PersonalCare Plans are offered only in King, Snohomish, and Pierce counties and include six Partner Systems:
- EvergreenHealth Partners
- MultiCare Connected Care
- Northwest Physicians Network
- The Everett Clinic Integrated Care Network
- UW Medicine Accountable Care Network
- Virginia Mason Medical Center
Treating PersonalCare Plan patients referred to you by a Partner System
- Always check to see whether the patient has a PersonalCare Plan. PersonalCare Plan member ID cards include the name of their PersonalCare Partner System.
- Partner Systems can refer their patients to providers in the Heritage Signature/Heritage Prime networks. If a referral is needed, the Partner System will provide a referral so you can see the patient.
- Providers not in the Heritage Signature/Heritage Prime networks are out of network.
- If you see a PersonalCare Plan member, they may have to pay the total cost of the service out of pocket-the only exception is medical emergencies.
- See a complete list of services and provider types that don't require a referral.
Questions
For questions about Premera's PersonalCare Partner System network, email Physician and Provider Relations at provider.relationswest@premera.com.