Reminders and Updates Archives - Premera Providers (WA)

Reminders and Updates

Fee Schedule Maintenance

October 1, 2026

Learn about upcoming changes for dates of service beginning January 1, 2027.

Reminders and Updates

Prior Authorization Required for Partial Hospitalization Programs Starting October 9

September 3, 2026

Submit prior authorization before treatment and complete ongoing medical necessity reviews.

Reminders and Updates

Massage Therapy Utilization Review Ends January 1, 2027

September 3, 2026

Learn about the end of utilization review for massage therapy services.

Reminders and Updates

Premera Premier Provider Updates

August 6, 2026

Find refreshed provider designations in the provider directory.

Reminders and Updates

Fee Schedule Maintenance Policy Updates

July 9, 2026

We’ve updated our Fee Schedule Maintenance Policy to be more transparent about the changes we make throughout the year to keep your fee schedule updated.

Reminders and Updates

Fee Schedule Maintenance for Ambulatory Surgical Centers

June 4, 2026

Review updated codes for ambulatory surgical center settings.

Reminders and Updates

Better Care Through Population Health

May 7, 2026

Learn about our NCQA-aligned population health focus.

Reminders and Updates

Reminder: Formulary Drug List Updates

May 7, 2026

Don’t forget to check our formulary drug list.

Reminders and Updates

Correct Coding Keeps Claims Moving

April 2, 2026

Avoid edits and denials by using accurate coding.

Reminders and Updates

Your Role in Breastfeeding Success

April 2, 2026

Strengthen breastfeeding with early and ongoing support.

Reminders and Updates

Formulary Drug List Updates

April 2, 2026

Keep up to date on changes to our formulary drug list.

Reminders and Updates

Screening for Intimate Partner Violence and Abuse

April 2, 2026

Ask simple questions to keep patients safe.

Reminders and Updates

Fee Schedule Maintenance for Ambulatory Surgical Centers

March 5, 2026

Review updated codes for ambulatory surgical centers.

Reminders and Updates

Reminder: Availity Essentials Sign-In Change

March 5, 2026

Start using an authenticator app to sign in.

Reminders and Updates

Corrected 1099‑MISC Forms Coming Soon

February 5, 2026

Get details on 1099‑MISC forms and updates mailing February 6.

Reminders and Updates

Radiation Therapy Billing Update for 2026

February 5, 2026

Learn how the new coding impacts radiation therapy.

Reminders and Updates

Routine Test Management Program is Live February 6

February 5, 2026

Review key information about the new program.

Reminders and Updates

Get Ready: Substance Use Disorder Compliance Starts February 16

February 5, 2026

Refresh your process before the federal rule begins.

Reminders and Updates

Preventive Vaccines: Coverage for Your Patients

February 5, 2026

Encourage patients to stay current on fully covered shots.

Reminders and Updates

Expanded Surgery and Birth Sites Benefit

January 8, 2026

Access the new site of service benefit display in Availity Essentials.

Reminders and Updates

Blue High Performance Network® Reminder

January 8, 2026

Check if you’re a provider in the Blue High Performance Network.

Reminders and Updates

Appeals Fax Number Change

January 8, 2026

Update your office records today.

Reminders and Updates

Fee Schedule Maintenance for Ambulatory Surgical Centers

January 8, 2026

Review updated codes for ambulatory surgical center settings.

Reminders and Updates

Correct Modifiers Protect Payments

December 4, 2025

Use the right modifiers to stop claim denials before they start.

Reminders and Updates

Prepare Now: Substance Use Disorder Treatment

December 4, 2025

Secure consent before treating patients with substance use disorder.

Reminders and Updates

Reminder: Dental GRID Network Brings Members Nationwide Access

December 4, 2025

Sign up for Availity Essentials to check 2026 eligibility and benefits.

Reminders and Updates

New Imaging Program Launches in January

December 4, 2025

Review key information about new imaging site of service.

Reminders and Updates

Expanded Coverage Coming Soon for Hearing Aids

December 4, 2025

Find out what’s changing to cover patients with hearing aids.

Reminders and Updates

New Screening Rules Start January 1

December 4, 2025

Get the new recommendations for cervical and breast cancer screenings.

Reminders and Updates

More Choices for Surgeries and Pregnancies

December 4, 2025

Discover what’s changing in Availity Essentials for elective surgeries and low-risk births.

Reminders and Updates

Ambulatory Surgery Center Fee Schedule Maintenance

August 7, 2025

Find out the new codes for an ASC setting.

Reminders and Updates

Request a Call with a Premera Medical Director

July 3, 2025

Request a conversation using the phone number in the denial notification letter.

Reminders and Updates

Drug Site-of-Service Program Updates

July 3, 2025

Additional drugs will require prior authorization under the drug site-of-service medical policy.

Reminders and Updates

Reminder: Genetic Testing Requires Prior Authorization

June 5, 2025

Confirm requirements before sending samples to the lab.

Reminders and Updates

Members Receive In-Home Test Kits

June 5, 2025

Eligible members receive opt-in invitations for at-home test kits.

Reminders and Updates

Ambulatory Surgery Center Fee Schedule Maintenance

May 1, 2025

New April 2025 codes covered for ambulatory surgery centers.

Reminders and Updates

Free Continuing Medical Education Course: Lifestyle Medicine and Food as Medicine Essentials

May 1, 2025

Learn the essentials of lifestyle medicine for your practice.

Reminders and Updates

Fee Schedule Maintenance Update

April 3, 2025

We’re implementing updates to certain codes to establish fixed pricing methodologies.

Reminders and Updates

How to Submit a Corrected Claim

March 6, 2025

Follow these steps to avoid a processing delay.

Reminders and Updates

Automatic Approvals for Individual Plans in Ambulatory Surgery Centers

February 6, 2025

Prior authorizations submitted for 8 specific procedures in ambulatory surgery centers will be automatically approved.

Reminders and Updates

Ambulatory Surgery Center Fee Schedule Maintenance

February 6, 2025

New ambulatory surgery center codes for 2025.

Reminders and Updates

Wintertime Reminder: Vitamin D Testing

February 6, 2025

Check before you test to make sure vitamin D screenings are medically necessary.

Reminders and Updates

Medical Records Requests for 2025

February 6, 2025

Here’s when you can expect them for 2025.

Reminders and Updates

Submitting Appeals

January 6, 2025

Sending one appeal per patient helps us process your appeals faster.

Reminders and Updates

New Breast Exam Benefit for High-Deductible Plan Members

January 6, 2025

More members will have no cost shares for supplemental or diagnostic breast examinations.

Reminders and Updates

WA Senate Bill 6228 Brings New Rules for 2025

December 5, 2024

New rules are effective January 1, 2025, relating to the treatment of substance use disorders.

Reminders and Updates

Drug and Biologic Edits

December 5, 2024

Additional information about new drug and biologic edits.

Reminders and Updates

What to Know About the New Law Ensuring Access to Emergency HIV Post Exposure Prevention

December 5, 2024

Learn about new Washington state requirements for cost-sharing, prior authorization, and reimbursement for HIV post-exposure prophylaxis drugs.

Reminders and Updates

Postal Employees Added to Federal Employee Program Payer Starting January 1

November 7, 2024

Payer name changes in Availity to include postal members.

Reminders and Updates

Billing for Wasted and Administered Drugs

October 3, 2024

Drug waste will be reimbursed when billed with correct modifiers.

Reminders and Updates

Adding a Description for Unlisted Procedure Codes

October 3, 2024

Include a description of the service rendered when billing an unlisted procedure code.

Reminders and Updates

Reminder: Availity Essentials Claim Denial Messaging Enhancement Now Live

09/05/2024

Reminders and Updates

Reminder: FEP Paper Explanation of Payments Ending August 1

8/1/2024

Reminders and Updates

Air Ambulance Patient Transportation

07/08/2024

When is it appropriate for your patient?

Reminders and Updates

Refer Patients to In-Network Providers

07/08/2024

Help reduce your patients’ out-of-pocket costs.

Reminders and Updates

Annual Risk Adjustment Data Validation Audits

07/08/2024

Your office may receive a request for medical records.

Reminders and Updates

Preventive Service Updates Coming in July

June 6, 2024

Mark your calendar for benefit changes effective July 1.

Reminders and Updates

FEP Paper Explanation of Payments Ending August 1

May 2, 2024

Paper FEP explanation of payments ending August 1 for those using electronic funds transfer.

Reminders and Updates

Durable Medical Equipment Modifiers and Units

May 2, 2024

Make sure to append the correct modifier and number of units.

Reminders and Updates

Upcoming Durable Medical Equipment Edits

April 4, 2024

Durable medical equipment edits are coming to the claims editor.

Reminders and Updates

Correct Coding Edits Coming to Claims Editor

April 4, 2024

Correct coding of diagnosis codes, procedure codes, and place of service codes to be implemented.

Reminders and Updates

Provider Directory: Are You Verified?

March 7, 2024

Comply with No Surprises Act requirements and verify your information with BetterDoctor.

Reminders and Updates

New Search Function Launches on Premera Provider News Website

March 7, 2024

Find the articles you need easier than ever.

Reminders and Updates

New Payment Policy: Medically Unlikely Edits

March 7, 2024

Maximum daily units in claims editor explained.

Reminders and Updates

Flovent HFA Discontinued by GlaxoSmithKline

February 1, 2024

Premera is expanding its formulary to include generic Fluticasone HFA.

Reminders and Updates

New Drug and Biologic Edits

February 1, 2024

New drug and biologic edits will be implemented to support medical and pharmacy policies.

Reminders and Updates

New Video Helps Members Find a Doctor

February 1, 2024

Check out our new three-minute video and learn how to update your provider directory information.

Reminders and Updates

InstaMed Updates Needed for Individual Plan Network Providers

February 1, 2024

Follow these simple steps to ensure you receive InstaMed autopayments in 2024.

Reminders and Updates

RA Modifier Pricing Update

February 1, 2024

90-day notice of changes for claims including an RA modifier.

Reminders and Updates

Dexcom G6 and G7 Transmitter and Sensor Failures

December 7, 2023

Recent sensor failures are not detecting correct blood sugar levels.

Reminders and Updates

Preventive Benefit Updates for January 1, 2024

December 7, 2023

Changes are in store for preventive benefits in 2024.

Reminders and Updates

Upcoming 2024 Claims Editing Projects

December 7, 2023

Upcoming 2024 claims editing projects.

Reminders and Updates

Protect Your Patients’ Information

December 7, 2023

Prior authorization requests must be re-submitted if attachments for more than one member are included.

Individual Network Providers: Critical Steps for EFT Payments

Reminders and Updates

Speech Therapy Coding Changes Coming January 1, 2027

Fee Schedule Maintenance

Prior Authorization Required for Partial Hospitalization Programs Starting October 9

Massage Therapy Utilization Review Ends January 1, 2027

Premera Premier Provider Updates

Fee Schedule Maintenance Policy Updates

Fee Schedule Maintenance for Ambulatory Surgical Centers

Better Care Through Population Health

Reminder: Formulary Drug List Updates

Correct Coding Keeps Claims Moving

Your Role in Breastfeeding Success

Formulary Drug List Updates

Screening for Intimate Partner Violence and Abuse

Fee Schedule Maintenance for Ambulatory Surgical Centers

Reminder: Availity Essentials Sign-In Change

Corrected 1099‑MISC Forms Coming Soon

Radiation Therapy Billing Update for 2026

Routine Test Management Program is Live February 6

Get Ready: Substance Use Disorder Compliance Starts February 16

Preventive Vaccines: Coverage for Your Patients

Expanded Surgery and Birth Sites Benefit

Blue High Performance Network® Reminder

Appeals Fax Number Change

Fee Schedule Maintenance for Ambulatory Surgical Centers

Correct Modifiers Protect Payments

Prepare Now: Substance Use Disorder Treatment

Reminder: Dental GRID Network Brings Members Nationwide Access

New Imaging Program Launches in January

Expanded Coverage Coming Soon for Hearing Aids

New Screening Rules Start January 1

More Choices for Surgeries and Pregnancies

Ambulatory Surgery Center Fee Schedule Maintenance

Request a Call with a Premera Medical Director

Drug Site-of-Service Program Updates

Reminder: Genetic Testing Requires Prior Authorization

Members Receive In-Home Test Kits

Ambulatory Surgery Center Fee Schedule Maintenance

Free Continuing Medical Education Course: Lifestyle Medicine and Food as Medicine Essentials

Fee Schedule Maintenance Update

How to Submit a Corrected Claim

Automatic Approvals for Individual Plans in Ambulatory Surgery Centers

Ambulatory Surgery Center Fee Schedule Maintenance

Wintertime Reminder: Vitamin D Testing

Medical Records Requests for 2025

Submitting Appeals

New Breast Exam Benefit for High-Deductible Plan Members

WA Senate Bill 6228 Brings New Rules for 2025

Drug and Biologic Edits

What to Know About the New Law Ensuring Access to Emergency HIV Post Exposure Prevention

Postal Employees Added to Federal Employee Program Payer Starting January 1

Billing for Wasted and Administered Drugs

Adding a Description for Unlisted Procedure Codes

Reminder: Availity Essentials Claim Denial Messaging Enhancement Now Live

Reminder: FEP Paper Explanation of Payments Ending August 1

Air Ambulance Patient Transportation

Refer Patients to In-Network Providers

Annual Risk Adjustment Data Validation Audits

Preventive Service Updates Coming in July

FEP Paper Explanation of Payments Ending August 1

Durable Medical Equipment Modifiers and Units

Upcoming Durable Medical Equipment Edits

Correct Coding Edits Coming to Claims Editor

Provider Directory: Are You Verified?

New Search Function Launches on Premera Provider News Website

New Payment Policy: Medically Unlikely Edits

Flovent HFA Discontinued by GlaxoSmithKline

New Drug and Biologic Edits

New Video Helps Members Find a Doctor

InstaMed Updates Needed for Individual Plan Network Providers

RA Modifier Pricing Update

Dexcom G6 and G7 Transmitter and Sensor Failures

Preventive Benefit Updates for January 1, 2024

Upcoming 2024 Claims Editing Projects

Protect Your Patients’ Information

Individual Network Providers: Critical Steps for EFT Payments