Identification Cards

Capture all ID card data at the time of service to verify membership and coverage.

• Ask for a current ID card at each visit to determine if any plan or benefit changes have occurred
• Copy the front and back of the ID card and share the information with your billing staff
• Transfer information to the claim exactly as it is presented on the card
• Check the date printed

Premera’s mobile app allows members to either provide mobile proof of coverage as a page on their phone or to email a proof of coverage document to a provider’s secure email address.

The front of the ID card identifies the member's plan and contains coverage and cost-share information, as well as claim submission information. Here's what to look for when reading the front of our member ID card:

• Rx: This symbol is used if the member has prescription coverage.
• Copayment information: Indicates the amount that the member pays at the time of service. Copay amounts vary by plan. Check the member's ID card or contact Customer Service at the number on the back of the ID card for the specific copay amount. Some larger accounts may request that copayment amounts not be displayed on the ID card.
• BlueCard: As a Premera-contracted provider, you can render services to patients who are members of other Blue Cross and/or Blue Shield plans, and who travel or live in your state. The BlueCard Program enables members of one Blue Cross and Blue Shield (BCBS) plan to get healthcare services while traveling or living in another Blue plan's service area. The suitcase symbols are important when providing healthcare services to out-of-area patients who belong to the BlueCard Program.
• • A blank suitcase symbol on a member's ID card indicates that the member's plan includes BlueCard benefits. The suitcase symbols are important when providing healthcare services to Blue Cross Blue Shield out-of-area patients.
  • PPO in the suitcase lets you know that this patient is covered under a BlueCard PPO plan.
• Group number: Internal number assigned to each group that chooses Premera as their health plan.
• Plan prefix: The prefix in front of the member's ID number identifies the member's specific Blue Cross Blue Shield plan. Include the prefix on all member claims to ensure that the claim is routed correctly for adjudication and payment.
• ID number: Each member is assigned an identification number. You must submit the member's ID number on all claims and correspondence exactly as displayed on the members ID card. Premera does not use a Social Security number (SSN) on member ID cards. We assign a unique number preceded with a three-digit prefix.
• Plus 1: Indicates that the plan has out-of-network benefits. Plus 1 is not the name of a plan/network or contracted product. It is added after the member's plan to indicate that the member has out-of-network coverage (but at a reduced benefit level).
• Date printed: This date is not the member's start date. Generally, if the member's plan has not changed, we do not issue a new ID card every year. A member's card is still valid even if it is more than two years old, though we recommend that you confirm that the member has not received a new ID card.

The back of the card provides important information, including:

• Billing instructions and address for paper claims specific to the member's plan
• To expedite payment, use the P.O. Box printed on the back of the member's ID card when billing paper claims.
• Web address for coverage and health-related information (premera.com)
• Phone numbers for assistance:
• • Member's Customer Service department
  • BlueCard^® provider locator
  • BlueCard^® eligibility
  • Pharmacy locator (if applicable)

Contact phone numbers for hospital and professional claims are listed on the back of the ID card. For all hospital claims, members should contact Premera Blue Cross at 800-562-1011. The contact phone number for professional claims in eastern Washington is 800-562-1011 (except Walla Walla, Clarke, Garfield, Columbia & Asotin counties). For professional claims inquiries in Western Washington contact Regence BlueShield at 800-552-0733.