Submitting Prior Authorization

  • NOTICE: Prior authorization requirements temporarily waived for SNF transfers

    Due to the increase in COVID-19 related admissions, we’re temporarily waiving the prior authorization requirement for skilled nursing facilities (SNFs) effective September 7, 2021, through October 31, 2021. For details, view the intermediate levels of care section on the Admission Notification page.

    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 submission websites

    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.

    Individual plan members

    Code list

    (ID cards specify Individual Plan)

    Sign in

    Out-of-area providers

    Get info on submitting prior authorization as a provider outside of WA or AK.

    Learn more

    Federal Employee Program (FEP) members

    View the FEP-specific code list and forms.

    Learn more

    Shared Administration

    Prior authorization contacts vary for Shared Administration groups.
    View the Shared Administration contact list for details.