Peak Care

  • Peak Care is a collaboration between MultiCare and Premera Blue Cross. Peak Care is available for Pierce County employers and uses the MultiCare Connected Care (MCC) Clinically Integrated Network, known as the Tahoma network, for this product. Under a Peak Care plan, the patient’s doctors, specialists, and hospitals work together to streamline care and keep costs as low as possible.

  • Peak Care uses the Tahoma network, an exclusive provider organization (EPO) network consisting of:

    • MultiCare Connected Care clinically integrated network
    • Chiropractic, naturopathic, acupuncture, and massage therapy providers in Pierce County
    • Essential community providers serving high-risk, special needs, medically underserved individuals

    MCC is committed to working with Premera as a member’s central point of care. As a designated primary care provider (PCP), you coordinate your patient’s care with specialists and hospitals within the Tahoma network to make sure everyone stays focused on the member’s needs. You can see the full roster of participating providers by using the Peak Care Find a Doctor tool.

    Members must seek care within the Tahoma EPO network. Members who receive care outside of the Tahoma network may have to pay the full cost for care – except for medical emergencies. If a specialist isn’t part of the Tahoma network, a Tahoma network provider may request a benefit level exception for the patient, following standard process, by calling Provider Customer Service at 800-722-1471. Documentation on the reason for the request is required.

    Member ID cards include Peak Care and list Tahoma as the network, as shown below:

    Be sure to verify eligibility and benefits before seeing Peak Care patients. Check the member’s ID card to validate coverage.

    • Urgent care services (Immediate Clinic, MultiCare Urgent Care, Indigo Urgent Care) are included in the Tahoma network. In addition to the Tahoma network of providers, patients also have access to a free 24-Hour NurseLine and virtual care services powered by Teladoc®.
    • Non-emergency services outside the Tahoma network aren’t covered and members may be responsible for the full cost of care.
    • Urgent care services received outside of the Tahoma network are not covered.
    • As a PCP, you take the lead in making sure your Peak Care patients see a specialist when needed and help them select the best facility for a procedure.
    • You verify member eligibility and network access.
    • You help your patients schedule free annual preventive checkups with your primary care practice. If medical conditions are addressed during the preventive visit, there may be a member cost share.

    Peak Care members may be responsible for the full cost of care if they see a provider outside the Tahoma network, except for emergency services. Tahoma network providers may refer to an out-of-network provider in certain situations.

    Claims for Peak Care members are submitted the same as any other claim for Premera. Submit a claim or track a claim.

    Use our code check tool to see if a recommended procedure or service requires review. To submit prior authorization requests and check status, use our secure prior authorization tool.

  • For more information

    If you have any questions about Peak Care or the Tahoma network, call 800-722-1471.