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Peak Care is a collaboration between MultiCare and Premera Blue Cross. Peak Care is available for Pierce, Thurston, and Spokane County employers and uses the MultiCare Connected Care (MCC) Clinically Integrated Network and Physicians of Southwest Washington’s select 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:
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. Use the All Networks search to select the member’s network from the list (Tahoma or Tahoma and Dental Choice, as noted on the member’s ID card).
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:
Sign in to Availity to verify eligibility and benefits before seeing Peak Care patients. Check the member’s ID card to validate coverage.
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. Sign in to Availity to submit a claim.
Sign in to Availity to use our code check tool to see if a recommended procedure or service requires review. To submit prior authorization requests and check status, use the Availity secure prior authorization tool.
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If you have any questions about Peak Care or the Tahoma network, call 800-722-1471.