Premera Hospital Billing FAQs

Premera Blue Cross works with CERIS and Carewise Health (CWH) to check hospital bills (claims) for accuracy. You can find two new FAQs in the Premera payer space in Availity Essentials to learn about these billing checks.

Pre-Payment Reviews (CERIS)

• Checks inpatient and outpatient hospital bills more than $50,000.
• Looks for mistakes, double charges, and items that shouldn’t be billed.
• Requires flagged claims to include a detailed list before they can be processed.
• Disagree? Call Premera at 844-868-0058 or email CERIS customer service.

Post-Payment Reviews (CWH)

• Audits paid hospital bills for coding and contract compliance.
• Gives providers 30 days to submit requested documentation.
• Disagree? Contact CWH at 502-326-4526 with questions.

What You Should Do

• Respond to requests from CERIS and CWH to avoid delays and denials.
• Follow all steps and deadlines for appeals.
• Contact your Premera provider representative for more support.