- Premera does not
permit fragmented or split professional billing which is defined as
professional services rendered by the same provider for the same date of
service and submitted on multiple professional claim forms.
- All services rendered by the same provider for the same member and date of service must be billed on a single claim form. Premera has claim edits in place to ensure accurate claims processing.
Note: The information above is applicable to most services.
Providers are required, by contract, to bill claims with complete and accurate
coding that reflect actual services performed at the time of service. CPT codes
can change over time and Premera expects all BH-ASOs and providers to stay
current on billing regulations and guidelines. If billing for anything other
than mobile crisis services, or if you have questions, call provider customer service
at 877-342-5258, option 1.