Premera requires prior authorization for many services before they take place. Not getting prior authorization beforehand can result in a payment penalty for you or the member. For a service requiring a pre-service review, there isn’t a penalty, but Premera
will hold the claim and ask for medical records Note: Prior authorizations can't be submitted by phone.
Prior authorization requests are submitted on different websites for 2020 individual and non-individual plan members (groups, associations, etc.). Sign in to the appropriate website to complete your request.
Code list and code check tool
Prior authorization resources
(ID cards specify Individual Plan)
Get info on submitting prior authorization as a provider outside of WA or AK.
View the FEP-specific code list and forms.
Prior authorization contacts vary for Shared Administration groups.View the Shared Administration contact list for details.