Contact Information, Confidentiality, and Appointment Access

Each contracted provider is assigned to a Provider Network Executive (PNE) or Provider Network Assosicate (PNA) at Premera. Call 877-342-5258, option 4 to speak with your PNE or PNA.

PNRs quickly handle your requests and resolve non-claims issues. Email us at Provider.RelationsWest@Premera.com, please remember to include the tax ID number, NPI numbers, and provider names related to your request.

• Address changes
• Tax ID number updates
• Telephone number changes
• Clinic opening or closing
• Additions to your clinic
• Practitioner/dental retirement, etc.

See self-service options on our contact us or learning center pages.

Call Premera Blue Cross at 800-722-1471.

Protected Personal Information is any and all information created or received by the company that identifies or can readily be associated with the identity of an individual, whether oral or recorded in any form or medium, that directly relates to the:

• Past, present, or future physical, mental, or behavioral health or condition of an individual
• Past, present, or future genetic information of the individual or their dependent, or relative of either
• Past, present, or future payment for the provision of healthcare to an individual
• Provision of healthcare to an individual
• Past, present, or future finances of an individual, including, without limitation, an individual's name, address, telephone number, Social Security Number, subscriber number, or wage information

We're committed to maintaining the confidentiality of individuals' protected personal health and financial information (collectively referred to as “protected personal information” or PPI). Premera collects, uses, and discloses PPI solely for routine business functions or as required or permitted by law or regulation. We strictly prohibit the unauthorized disclosure of PPI by our associates and business associates, unless we have first obtained the member's written authorization.

We understand that you value standards of confidentiality as a healthcare professional. As a contracted physician or provider, you're required to maintain the confidentiality of all PPI concerning any current or former patients (our members). In addition, you're also bound to observe certain state and federal privacy laws. At a minimum, each clinic should have each staff member sign a confidentiality statement upon employment in which the employee acknowledges the importance of maintaining the confidentiality of PPI. This is a Premera office site standard used in our credentialing and recredentialing process.

The “authorization for treatment” that you obtain from Premera members prior to rendering services authorizes you to disclose general health information to us. The validity of such an “authorization for treatment” isn't limited to 90 days, and such disclosures don't need to be documented in the member's medical chart. State and federal privacy laws allow physicians and providers to disclose PPI to Premera without the patient's authorization for payment purposes and healthcare operations such as:

• Determining eligibility
• Utilization and medical/dental necessity reviews
• Healthcare operations activities (e.g., case and care management, quality reviews)

Any activity undertaken by the company, or by a business associate on behalf of the company, for healthcare operations and payment activities:

• Carrying out the management functions of the company, examples include: underwriting, actuarial, care management, case management, and quality reviews
• Obtaining subscription charges
• Determining or fulfilling its responsibility for coverage under the health plan and for the provision of benefits under the health plan, examples include: member benefit eligibility, payment of member claims, and coordination of member benefits with other insurance carriers or liable third parties