Reminders and Updates - Provider News

Enhancing Accessibility: New Method for Submitting Medical Records | 11/6/2023

You can now submit medical records for claims processing via fax

New COVID-19 Vaccines Available | 10/6/2023

Updated information on COVID-19 vaccines, billing, and codes

Shining a Light on At-Home Treatment Options for Skin Conditions | 10/5/2023

Consider at-home photo therapy as a potential treatment option before opting for biologics

New Edits for First-Pass Claims Editor | 10/5/2023

Upcoming new edits will enforce Payment Policy and Correct Coding guidelines

Provider Directory Notice: Check Your Status with BetterDoctor | 10/5/2023

Here’s what you need to know about BetterDoctor and verifying your information with Premera Blue Cross Blue Shield of Alaska

UPDATE: Optum Financial Moves to Virtual Credit Card (Vcard) Payment | 10/5/2023

Window for processing Vcards before a check is sent moving from 45 days to 30

Consultation Code Services Payment Policy Expanding to Include Alaska Providers | 9/7/2023

New policy takes effect December 11, 2023

Modifier 90 Reference/Outside Laboratory Policy Expansion to Include Facility Claims | 9/7/2023

Facility claims submitting lab services with Modifier 90 will be denied reimbursement

Notification of Recredentialing Completion | 9/7/2023

Letters being sent to providers to inform them their recredentialing process is complete

New Provider Customer Service Hours | 8/3/2023

Provider customer service hours are now 6 a.m. to 5 p.m

Survey Ends on August 8 | 8/3/2023

Help us improve the Premera provider experience

Be Alert for Scam Callers | 8/3/2023

Scam vendors may call for patient information

Premera Welcomes Matanuska-Susitna Education Association Union Employees | 7/6/2023

Employees of Matanuska-Susitna Borough School District will receive benefits through Premera Blue Cross Blue Shield of Alaska

Preventive Service Updates Rolled Out July 1 | 7/6/2023

Learn about changes to our preventive care benefits

Avoid Removal from the Provider Directory | 7/6/2023

Important information to help you keep your provider data current and visible

Reminder to Check Eligibility and Benefits | 7/6/2023

Services and pharmacy benefits may change for some employer groups who customize their plans

Reminder: Claims Editor Changes Starting on July 8 | 6/1/2023

The new claim editor will continue to enforce correct coding and billing practices and evaluate current claims against Premera’s historical claims for editing purposes

Health Sector Coordinating Council Releases “Cybersecurity for the Clinician” Video Training Series | 5/4/2023

This series explains the basics for how cyber-attacks can affect clinical operations and patient safety

How To Submit a Corrected Claim | 5/4/2023

The preferred process for submitting corrected claims is to use the 837 transaction for both professional and facility claims, and the claim frequency code 7

Help Keep Your Provider Data Current | 5/4/2023

Updating your information can ensure you’re meeting federal requirements for provider data

COVID-19 PHE Requirements ending May 11, 2023 | 5/4/2023

The federal government has rescinded many of the requirements put in place during the COVID-19 Public Health Emergency (PHE). The following changes will be effective May 11, 2023

Optum Financial Moves to Virtual Credit Card Payment | 4/6/2023

You can change your payment method through Optum Financial

New Quality and Coding Tools for Premera Providers | 4/6/2023

Visit our new web page for quality measures and coding tip sheets

End of the Public Health Emergency Brings Changes to Payment Policies | 4/6/2023

Premera will be updating payment policies to reflect the federal government ending the COVID-19 public health emergency

New Edits for Drug Waste on Professional and Facility Claims | 4/6/2023

Review the details in these policies to learn how to correctly code for drug wastage

Keep Your Provider Data Current | 3/2/2023

Information to help you ensure you’re meeting federal requirements for provider data

AIM Specialty Health Transitioned to Carelon | 3/2/2023

AIM Specialty Health changed its name to Carelon Medical Benefits Management on March 1, 2023

How To Submit Admission Notification | 3/2/2023

Information to help you ensure you’re meeting federal requirements for provider data

AIM Specialty Health Transitions to Carelon | 2/2/2023

AIM Specialty Health will have a new name, Carelon, on March 1, 2023

Preventive Services Updates for 2023 | 12/1/2022

Changes to our preventive care benefits are coming in January

Making Provider Directory Accuracy a Priority | 12/1/2022

Premera is working with BetterDoctor to ensure the accuracy of your information in our provider directory

Stay Up to Date on All Payment Policy Changes | 12/1/2022

Review the latest payment policy updates for changes that may affect your claims payment

Prevent Claim Edits and Denials with These Tips | 11/3/2022

If a procedure code doesn’t match the anatomic site of the modifier, the procedure code will be denied - learn more tips

Participate in the 2022 Provider Survey | 10/6/2022

Help Premera better serve our providers and members

Upcoming Changes to CPT Evaluation and Management Coding | 10/6/2022

The American Medical Association revised the E&M coding guidelines and code descriptions

Premera Pulse Ending | 10/6/2022

Features like finding in-network care, accessing medication lists, and reminders will be available in other programs

Reminder: Title Revision for Physical, Occupational, and Speech Therapy Services Payment Policy | 10/6/2022

In July 2022, the title of physical, occupational, and speech therapy services payment policy was updated and the policy code 97127 was removed

New Payment Policy: Place of Service Codes | 9/1/2022

Learn more about place of service (POS) codes that don’t reflect where a service was performed or received

Changes to Group Psychotherapy Policy | 9/1/2022

Policy exceptions being removed from policy

Botulinum Toxins will Require a Prior Authorization | 9/1/2022

Read more about the new medical policy

Provider Directory Notice: Check Your Status with BetterDoctor | 9/1/2022

Premera is working with BetterDoctor to ensure the accuracy of your information and meet provider directory requirements in the federal No Surprises Act

Premera Premier Provider Program Introduces Enhancements | 8/4/2022

Enhancements include robust data for inpatient and outpatient quality measurements, extended review periods, and more

DataWise: Premera’s Interoperability Program | 8/4/2022

See how interoperability data sharing can help close gaps and improve health outcomes

Provider Taxonomy Codes Needed on Claim Forms | 7/7/2022

Add your specialty taxonomy code to claims to assist in correct editing

Preventive Services Updates For 2022 | 6/2/2022

Learn about changes to our preventive care benefits

Overpayment Recovery Update | 4/1/2022

Effort for being made to reduce our carbon footprint by reducing mailing and streamline work for providers

New Payment Policy: COVID-19 Testing | 4/1/2022

Diagnostic testing, surveillance testing and over the counter tests reviewed

Audio-only Telehealth Modifiers | 4/1/2022

Audio-only services need to be identified by adding one of the new audio-only modifiers

Applied Behavior Analysis Services Through Telehealth Extended | 4/1/2022

The allowance for applied behavioral analysis (ABA) services provided via telehealth has been extended through June 30, 2022

Waiver of Medical Necessity Requirements | 4/1/2022

The waiver for authorization requirements for transfers to lower levels of care and medical necessity requirements for air/ground transportation ends April 16, 2022

Electronic Remittance Tips | 2/24/2022

Enroll with Premera and InstaMed to ensure you receive all electronic remittance

Add Your Bio/Photo to Our Provider Directory | 2/24/2022

Upload up to 20 images at a time

Total Joint Replacement Program Has Expanded to Alaska | 2/24/2022

Alaska members now have access to the Total Joint Replacement bundle

Availity Essentials Secure Provider Website Updates | 2/24/2022

Here are some helpful tips for using Availity

Over-the-Counter COVID-19 Testing and Government Tests | 2/3/2022

Health plans are required to cover member-purchased over-the-counter (OTC) COVID-19 tests

New Code for Post COVID-19 Conditions | 1/6/2022

This code is for conditions which are the consequence of COVID-19.

AIM Provider Portal Changes | 1/6/2022

AIM provider portal allows users to see the order ID on all authorization requests.

Enhanced Edits Based on Provider Specialty | 1/6/2022

Provider’s specialty and tax identification number will be used to determine application of edits.

No Surprises Act: Understanding Balance Billing Rules | 12/16/2021

Learn about the balance billing rules coming with the No Surprises Act in 2022.

Understanding the No Surprises Act Dispute Resolution Process | 12/16/2021

Learn about the new federal dispute resolution provisions starting January 1, 2022.

Pre-Certification Required for FEP Member Inpatient Stay | 12/16/2021

If the Federal Employee Program (FEP) member’s admission is not pre-certified for an inpatient stay, FEP may not provide benefits.

Preventive Services Update: Colorectal Cancer Screenings | 12/16/2021

Learn about an age range change to our preventive benefits for colorectal cancer screenings.

Telehealth Place of Service Code | 12/16/2021

New place of service code for telehealth provided in patient’s home.

Pre-certification will be Required for FEP Members Inpatient Stays | 12/2/2021

Pre-certification will be required for inpatient stays for all Blue Cross and Blue Shield Federal Employee Program (FEP) members

Pediatric COVID-19 Vaccine Codes and Eligibility | 11/18/2021

Vaccine codes are now available for children ages 2-11.

Codes and Eligibility for COVID-19 Booster Shots | 11/18/2021

Use the correct codes when submitting claims for COVID-19 vaccines and boosters.

Billing for Delivery and Postpartum Care Services | 11/4/2021

Only one submission of postpartum care will be allowed per pregnancy.

Understanding Provider Directory Requirements for the No Surprises Act | 11/4/2021

Learn about the new provider directory rules starting January 1, 2022.

Telehealth/Virtual Encounter Documentation and Billing Guidelines | 11/4/2021

Correctly code your telehealth encounter for reimbursement.

Federal No Surprises Act Explained | 10/21/2021

What you need to know about the new legislation taking effect January 1, 2022.

New Process in 2022 for Specialized Therapy Requests | 10/21/2021

Effective January 3, 2022, eviCore is updating its clinical collection process for specialized therapy requests.

Prior Authorization Required for Hysterectomy Surgeries in 2022 | 10/7/2021

Prior authorization and site of service will be required for hysterectomy for dates of service January 7, 2022 and beyond

Update to PrEP Preventive Services Coverage | 9/16/2021

Learn about an important change to our preventive care benefits for pre-exposure prophylaxis

New Payment Policy: Therapy Assistant Modifiers | 9/16/2021

Physical therapy and occupational therapy assistant modifiers now required

Prior Authorization Requirements Temporarily Waived for SNF Transfers | 9/16/2021

We’re temporarily waiving the prior authorization requirement for skilled nursing facilities

Inpatient Stays will Require Pre-certification for FEP Members | 9/16/2021

If a precertification isn’t done for FEP inpatient stays, payments will be reduced

Extending Length of Approval for Prior Authorizations | 9/16/2021

Premera has extended the length of approval for prior authorizations to 180-days

Help Premera Provide Timely and Efficient Care for Our Members | 9/2/2021

The network awareness survey ensures our providers and staff are aware of our available networks

Provider Workshop: Claims Editing | 9/2/2021

Join us for an overview of our claims editing process and the implementation of coding validation

Hospital and Hospital System Readmission Payment Policy Revisions | 9/2/2021

Find out more about significant content changes to this policy

Provider Directory Verification is Moving to Better Doctor | 8/19/2021

We’re streamlining the verification process to comply with federal regulations

Philips Respironics Recalled Ventilators, BiPAP and CPAP Machines | 8/19/2021

Learn more about the Philips Respironics recall

Third COVID Vaccine Dose Approved | 8/19/2021

A third dose is recommended for patients with moderate or severe primary immunodeficiency

Expanded Prior Authorizations for BlueCard® Members | 8/5/2021

Some BlueCard members need prior authorization for elective or non-emergency outpatient radiology or cardiac imaging services

New Tools to Estimate Patient Costs will be Introduced in 2022 | 8/5/2021

The real-time estimator tool no longer available

Transparency in Coverage Rule | 7/2/2021

What is this new rule and what will Premera do to comply.

New Prior Approval Form for FEP | 7/1/2021

New Federal Employee prior approval form now available for Applied Behavior Analysis review requests

Health Plans Now Required to Provide Access to Patient Clinical Records | 7/1/2021

New requirements give members timely access to their health data to better manage their own care

Updates to CMS Guidance on Telehealth Visits | 7/1/2021

Telehealth reimbursements change on September 1, 2021

Payment Policy Revisions | 6/3/2021

Recent revisions to payment policies affect claims payment

Real-Time Estimator Tool Remains Unavailable | 6/3/2021

Our real-time estimator tool remains down for maintenance until further notice

New Policy for Lab Billings | 6/3/2021

Billing guidelines for laboratory and pathology services

Preventive Services Updates for 2021 | 6/3/2021

Learn about changes to our preventive care benefits

New Provider Update Form | 6/3/2021

The provider update form makes it easier to submit your provider, facility, or location updates online

COVID Treatment Cost Shares ends June 30 | 6/3/2021

The COVID treatment cost share waiver will end on June 30, 2021

Handwritten Fax Forms No Longer Accepted Starting June 1 | 5/14/2021

Starting June 1, we’re only accepting electronic prior authorization fax forms

Personal Health Support Programs | 5/14/2021

Premera offers a personalized, one-on-one support program to help your patients manage their condition

Credentialing TIN Requirement Update | 5/6/2021

Send us your SS-4 letter instead of W-9

Refund Payment Format Updated | 5/6/2021

Premera is reducing its carbon footprint and streamlining work

Annual Risk Adjustment Data Validation Audits | 5/6/2021

Offices may receive a request for medical records from Cognisight or Premera

Don’t Forget the Signed Member Authorization | 5/6/2021

A signed member authorization is needed for appeals submitted on the member’s behalf

2021 Provider Workshops | 4/9/2021

Join Premera for online training and educational opportunities

Contract Exclusions Payment Policy | 4/9/2021

Clarification for the Contract Exclusions payment policy

OneHealthPort Multi-Factor Authentication Begins on May 10 | 4/9/2021

Multi-Factor Authentication will be added to OneHealthPort's Single Sign-On service

Patients Can Get More Control of Their Health Data | 4/9/2021

New rules require health plans to provide patient clinical records access within 24 hours

New FEP Fax Cover Sheet | 3/18/2021

This new form can save you time!

Alaska Fee Schedule | 3/4/2021

An update to the fee schedule for professional services is coming May 15, 2021.

Upcoming Facility and Professional Claim Edits | 3/4/2021

Edits will be enforcing correct coding of diagnosis codes and procedure codes.

Shared Administration Contact List | 2/18/2021

The Shared Administration Contact List can help you find what you need.

Provider Workshop: COVID-19 | 2/4/2021

Join Premera for a provider workshop to discuss the COVID-19 vaccine, billing and coding, virtual care, and more.

New Codes for Coronavirus and Vaccines | 2/4/2021

Providers must use new ICD-10 codes.

COVID-19 Vaccine Updates | 1/7/2021

What you need to know to administer the vaccine.

Has Your Office Information Changed Recently? | 1/7/2021

Make sure your information is also current in our provider directory.

New Steps for Admission Notification | 1/7/2021

You now have more time to submit medical records for admissions.

Updated Virtual Care Benefits | 1/7/2021

IOP and PHP virtual care are now standard benefits.

COVID-19 Vaccine Updates | 12/17/2020

What you need to know to administer the vaccine.

2021 ID Card Guide Available | 12/17/2020

View sample ID cards and learn about new plans, networks, and copays.

Provider Workshop: Premera 101 | 12/17/2020

Join us for an introduction to our secure online tools and quick tips for success.

Modifier 90 Edit Expansion to Facility Claims Rescinded | 12/3/2020

Coding edits for modifier 90 won’t be expanded to facility claims.

Eligibility and Benefits Workshop Overview | 11/19/2020

Highlights from the November 11 provider workshop.

Reimbursements for Some September Telehealth Claims | 11/19/2020

We’re reprocessing telehealth claims providers submitted to reimburse at the in person allowed amount.

MOBE Program Discontinuing | 11/5/2020

Premera will discontinuing the MOBE program effective December 31, 2020.

Virtual Care Documentation Best Practice | 11/5/2020

Are you documenting all the elements of a telehealth visit?

Take the Provider Directory Survey for a Chance to Win a Gift Card | 11/5/2020

Help us improve our provider directory.

Payment Policy: Personal Protective Equipment | 11/5/2020

Personal protective equipment (PPE) will no longer be separately reimbursable.

Repayment Begins for the Advance Payment Program on January 1 | 11/5/2020

Look for an email noting your options for repayment.

Modifier 90 Edit Extending to Facility Claims | 10/15/2020

Correct coding edits for modifier 90 will apply to facility claims.

Use Overpayment Forms When Returning Checks to Premera | 10/15/2020

Forms save a significant amount of administrative time for all.

Survey Results: Medical and Behavioral Health Collaboration | 10/15/2020

Learn more about the results and how they can help your practice.

Premera Extends the POS Payment of Telehealth Visits | 10/15/2020

Providers need to continue use the telehealth place of service (POS) 02 with the procedure code appended with either modifier 95 or GT.

Relocating? Learn About Continuing Out-of-State Telehealth Services | 10/1/2020

If your practice moves out of state, it’s possible we can continue to work together.

Complete the Provider Network Survey | 10/1/2020

Tell us how to improve our network information.

Billing Telehealth Services | 10/1/2020

Providers need to bill POS 02 for all telehealth services delivered after September 1.

Updates to Claims Editor/What If Tool | 9/17/2020

Check your claim in the What If Tool to identify potential edits.

Participate in Provider Network Awareness Survey | 9/17/2020

We’re working to ensure our ongoing efforts lead to timely and efficient care for our members.

Overpayment Recoupment Ending | 9/3/2020

Premera will begin recouping overpayments in September.

Upcoming New Professional and Facility Claim Edits | 9/3/2020

Additional correct coding claim edits will be applied to professional and facility claims.

Customer Service Hours Changing: Use Online Tools to Save Time | 9/3/2020

Provider customer service hours are changing to 8 a.m. to 5 p.m.

Tips for Billing a Telehealth Originating Site Fee | 8/20/2020

Learn what the originating site means for telehealth services.

Coding and Billing of a Telehealth Encounter | 8/20/2020

Telehealth services are returning to correct coding and billing of a telehealth encounter.

Coverage for Return-to-Work Antigen and Antibody Testing | 8/6/2020

Premera will not include molecular/antigen or antibody testing for return-to-work strategies.

New Payment Policy: Personal Protective Equipment | 7/16/2020

Personal Protective Equipment (PPE) will no longer be reimbursed.

Reviewing HCPCS C Codes for Medical Necessity | 7/16/2020

Premera will be reviewing HCPCS codes in the “C” series for medical necessity.

Save Time by Using the Correct Forms | 7/2/2020

Find out which 3 forms are the most commonly misused.