January 16, 2020
As of January 1, 2020, many Premera members are required to use a Premera-Designated Center of Excellence (COE) for total knee and total hip replacements (total joint replacement or TJR). In Washington, the COE is one of 7 Providence St. Joseph Health facilities.
What does that mean?
If a member doesn’t use a designated COE, they may be responsible for the total cost of care. This can be a significant cost for a member.
Why are we doing this?
Premera is focused on ensuring that our members receive the highest quality care at the lowest price. Following the Bree Collaborative guidelines, we selected these facilities from a request-for-proposal process as meeting the criteria.
What do you need to do?
If you have Premera patients who need total joint replacement, ask them to contact Premera customer service using the number on the back of their ID card to verify benefits.
Questions? Contact your Premera network executive.