Join Our Network

  • At Premera, we’re committed to maintaining a high-quality network of healthcare providers, organizations, and facilities. To become a contracted in-network provider and begin billing Premera for services, you must complete our systematic verification process.

    Credentialing first steps

    New provider resources

    Step 1. Qualifications 
    Providers in Washington state with an approved specialty can qualify for Premera contracts. Out-of-state provider contracts are limited—view our FAQ for more details.

    Step 2. Credentialing 
    Before requesting a contract with Premera, you must complete credentialing. This includes a background check to verify your professional details through a detailed, NCQA-compliant application process.

    Step 3. Contracting 
    Once credentialing is complete, you can sign an individual provider contract or join a contracted independent practice association (IPA) or medical group.

    Credentialing and contracting process for a new group of providers

  • Provider application process for credentialing

    All providers in a new group must be credentialed individually before the group can request a contract. 

    Credentialing steps for new group providers

    1. Confirm your provider type is on our list of approved specialties.
    2. Email provider.relations@premera.com if your specialty isn’t listed.
    3. Sign in to CAQH to complete and attest your provider profile.
    4. Go to the Authorization tab and select Premera Blue Cross or global for access to review your profile.
    5. Make sure your CAQH profile has your main email address. Certify will use it to send you application updates.
    6. Log in to Certify to submit your signed credentialing application.
    7. Certify will send you an email if additional information is required.

    Credentialing support

    How to avoid delays

    Before submitting your application, make sure all required documents, information, and signatures are included to help keep your credentialing process moving forward.

    Credentialing checklist for providers

    • CAQH access: Authorize Premera to review your CAQH profile.
    • Attestation: Attest your CAQH application within 90 days.
    • Professional details: Include your current professional contact information.
    • Work and education: Ensure your history is complete and up to date.
    • SS-4 form: Include your EIN if you're applying for a new contract.
    • Hospital privileges: List current privileges in your CAQH profile.  

    What to expect after submitting your application

    • Application acknowledgment: Certify will send you an email confirming receipt of your application.
    • Request for more info: We'll send you an email if additional information is needed.
    • Credentialing approval: You'll get an email confirming your application is approved. Refer to the FAQ for help if you’re not receiving emails from Certify.
    • Approval letter: You'll receive a welcome letter from Premera once credentialing is complete.
    • Contracting begins: We'll prepare and send your provider agreement for signature. Providers are not considered contracted until the agreement is finalized.
    • Agreement delivery: DocuSign will email your agreement for signature within 7 to 10 business days.
    • Signature deadline: Return the signed documents within 30 days to keep your request active.
    • Contract completion: Premera will countersign and finalize the agreement.
    • Final contract copy: DocuSign will send a copy of the finalized agreement with your effective date.

  • Credentialing new providers for an existing Premera contract

  • Credentialing process for new providers

    All new providers must complete our credentialing process before they can be added to a contract.

    Provider credentialing steps

    1. Confirm your provider type is on our list of approved specialties.
    2. Email provider.relations@premera.com if your specialty isn’t listed.
    3. Sign in to CAQH to complete and attest your provider profile.
    4. Go to the Authorization tab and select Premera Blue Cross or global for access to review your profile.
    5. Make sure your CAQH profile has your main email address. Certify will use it to send you application updates.
    6. Log in to Certify to submit your signed credentialing application.
    7. Certify will send you an email if additional information is required.

    Credentialing support

    How to avoid delays

    Before submitting your application, make sure all required documents, information, and signatures are included to help keep your credentialing process moving forward.

    Credentialing checklist for providers

    • CAQH access: Authorize Premera to review your CAQH profile.
    • Attestation: Attest your CAQH application within 90 days.
    • Professional details: Include your current professional contact information.
    • Work and education: Ensure your history is complete and up to date.
    • SS-4 form: Include your EIN if you're applying for a new contract.
    • Hospital privileges: List current privileges in your CAQH profile.  

    What to expect after submitting your application

    • Application acknowledgment: Certify will send you an email confirming receipt of your application.
    • Request for more info: We'll send you an email if additional information is needed.
    • Credentialing approval: You'll get an email confirming your application is approved. Refer to the FAQ for help if you’re not receiving emails from Certify.
    • Directory updates: Allow for 7 to 10 business days for new providers to appear in the provider directory as part of the contracted group.
    • Approval letter: You'll receive a welcome letter from Premera once credentialing is complete.

  • Adding credentialed providers to an existing Premera contract

  • How to add a Premera provider

    1. Complete the provider update form.
    2. Email a digital copy to provider.relations@premera.com.
    3.Allow for 5 to 7 business days to get a confirmation of the update.

  • Credentialed providers requesting a new contract

  • How to request a new contract

    Email us at providercontractservices@premera.com with the following required information. Providers are not considered contracted until the contracting process is complete.

    Required information

    • Copy of the SS-4 (EIN) or 147C letter from the IRS
    • Doing business as (DBA) name
    • Tax identification number (TIN)
    • Business address with remit/mail and note if it's only telehealth services
    • Business phone number
    • Email address for DocuSign contract delivery
    • Provider name and National Provider Identifier (NPI)
    • Updated roster with provider names and NPIs if ownership has changed
    • Business owner name
    • Requested contract effective date

    What to expect after submitting your application

    • Application acknowledgment: Premera will email you to confirm receipt of your contract request.
    • Agreement delivery: DocuSign will email your agreement for signature within 7 to 10 business days.
    • Contract completion: Premera will countersign and finalize the agreement.
    • Final contract copy: DocuSign will send a copy of the finalized agreement with your effective date.

  • Facilities requesting a new contract

  • How facilities request a new contract

    Facilities are typically large, institutionally owned healthcare organizations that offer comprehensive services. Facilities are state licensed and must complete a site survey. Examples include hospitals, skilled nursing facilities, home health agencies, hospice agencies, and ambulatory surgery centers (ASC).

    Requesting a facility contract

    Send us an email at provider.relations@premera.com with the following required information.

    Required information for facilities

    • Business legal name
    • Doing business as (DBA) name
    • Tax identification number (TIN)
    • Business specialty
    • Business address

    What to expect for the review process

    Our network team will review your request and follow up with next steps or any additional info needed.

  • Provider credentialing FAQ

  • The Council for Affordable Quality Healthcare (CAQH) is a nonprofit alliance of health plans and trade associations. It streamlines healthcare administration through technology and data solutions, notably through CAQH ProView, which supports provider credentialing and data sharing.
    Certify is a credentialing and provider data management website and platform adopted by Premera to streamline the provider credentialing and ongoing monitoring processes to make credentialing faster for providers.

    Check out the CAQH resources or call the CAQH help desk at 888-599-1771.

    View the Certify knowledge base centeror email gethelp@certifyos.com for application or portal issues.

    Certify may contact providers on Premera’s behalf if additional information is needed during the credentialing process. If you’re not receiving emails, check your junk or spam folder for messages from outreach@certifyos.com.

    Email us at credentialing@cerfiyos.com to request an update on your application.

    Credentialing is a background check that verifies healthcare providers through a detailed application process in accordance with NCQA standards. Providers must be credentialed before requesting a contract.

    Contracting is the process of a provider signing an agreement to join a health plan’s network. The contract outlines participation terms, including reimbursement, responsibilities, and the effective date.

    Providers practicing in counties bordering Washington may be eligible to apply for credentialing. Email us at provider.relations@premera.com for more information.

    Each provider in the group must complete credentialing before the group can request a contract. Once credentialing is approved, the group may submit a contract request. The group becomes part of the network after the contract is finalized and countersigned by Premera.

    Email providercontractservices@premera.com and include the contract name, full legal name as reported to the IRS, tax identification number (TIN), and your relationship to the provider. The contract will be emailed to you. 

    View the credentialing criteria and standards to learn more about our requirements.

    The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization that plays a pivotal role in improving healthcare quality across the United States.