Dual Licensed Providers

  • September 7, 2017

    Submitting claims to Premera just got easier for dual-licensed providers. Previously, claims from dual-licensed providers were frequently missing the appropriate credentials, causing claims to be returned. Dual-licensed providers can now submit their claims with the appropriate credentials and/or the appropriate taxonomy code.

    In order for this change to work, we need you to keep NPPES (National Plan and Provider Enumeration System) registry updated with each provider's most current license information. If you leave credentials off the claim, or list multiple credentials, we'll use the taxonomy code submitted with the NPPES registry to identify the correct credentials for the services provided.

    If you submit claims electronically, you're encouraged to contact your clearinghouse or software vendor for specifics on how to submit this information. If you submit claims by paper, the taxonomy code will be reviewed in box 24J. For any other questions, contact Premera EDI by email at EDI@Premera.com.

  •    Email this article