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- Premera Blue Cross Blue Shield of Alaska requires prior authorization for many services before they take place1. Not getting prior authorization beforehand can result in a payment penalty for you or the member1. For a service requiring a pre-service review, there isn’t a penalty, but Premera will hold the claim and ask for medical records1. To fax inpatient admission notification forms and related medical records, use 888-742-1487. To fax prior authorization request forms, use 800-843-11142. If you have questions, call 800-722-4714, option 3. For Individual Plan members, call customer service at 800-809-93613.
Learn more:✕This summary was generated using AI based on multiple online sources. To view the original source information, use the "Learn more" links.Premera Blue Cross Blue Shield of Alaska requires prior authorization for many services before they take place. Not getting prior authorization beforehand can result in a payment penalty for you or the member. For a service requiring a pre-service review, there isn’t a penalty, but Premera will hold the claim and ask for medical records.
www.premera.com/ak/provider/utilization-review/ab…Fax inpatient admission notification forms and related medical records to 888-742-1487. Fax prior authorization request forms to 800-843-1114.www.premera.com/ak/provider/contact-us/Some services require prior authorization in addition to admission notification and some services don’t require admission notification at all. It all depends on the type of admission and facility. If you have questions, call 800-722-4714, option 3. For Individual Plan members, call customer service at 800-809-9361.www.premera.com/ak/provider/utilization-review/ad… - People also ask
Submitting Prior Authorization | Provider - Premera Blue Cross
WebMany services require prior authorization. Submitting the request before the service helps Premera pay claims faster with no surprise cost to providers or the member. Submitting Prior Authorization | Provider | Premera Blue Cross Blue Shield of Alaska
Prior Authorization for Non-I…
Prior authorization through Carelon, eviCore, and more. Medical services. …
Forms
Care management and prior authorization. Credentialing and provider updates. …
Code Check Tool
Use Premera’s code check tool to check medical/dental codes to see if prior …
Providers Outside of Washin…
Providers outside of Washington or Alaska can use their current Availity state to …
Contact Us
Fax prior authorization request forms to 800-843-1114. Electronic Data …
Admission Notification
Prior authorization for planned procedures, surgeries: All planned procedures, …
Access
Whether your employees are healthy or managing a chronic condition, they can …
Drugs Requiring Approval
Note: This list shows drugs that require pharmacy prior authorization that are …
Individual Plan Tools and R…
You can submit a prior authorization for Premera Individual plan members using …
Providers
Provider Home | Provider | Premera Blue Cross Blue Shield of Alaska. Need to …
Availity - Premera
- Premera is now live on Availity for submitting prior authorizations and checking their status, submitting claims and getting claims status, and checking eligibility and benefits. Most of Premera’s secure tools on Premera.com are no longer available. The only tools that will remain are PCP roster, claims editor, and payment policies. You can link to...
Premera Blue Cross Blue Shield of Alaska
WebPrior Authorization. Check Prior Authorization Status. Claims & Payments. Electronic Funds Transfer for enrollment or cancellation requests. If you're already registered with Premera for EFT, no action is …
Homepage - Premera Providers (AK)
WebMay 2, 2024 · Premera Blue Cross Blue Shield of Alaska complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation.. Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield …
Healthcare Asks: What is Prior Authorization? - Premera …
WebFeb 15, 2024 · Prior authorization is an important tool to ensure that the services, drugs, and devices patients receive are supported by current, credible medical evidence and are administered by a clinician with the appropriate expertise and training.
Premera Answers FAQs about Premera Blue Cross HMO
WebHow do I submit a prior authorization? Submit all prior authorizations for Premera Blue Cross HMO through Availity, our secure provider portal. Note: The prior authorization medical policies used for Premera HMO are the same as Premera’s other commercial lines of business. View Availity quick guide for online provider tools. Is authorization ...
Protect Your Patients’ Information - Premera Providers (AK)
WebDecember 7, 2023. Prior authorization requests must only include clinical documentation for one member. We have recently seen an increase in requests containing multiple members’ information. This can result in a Personal Protected Information (PPI) breach.
Prior Authorization - Alaska Department of Health and Social …
WebPrior Authorization is required and issued for Alaska Medical Assistance recipients by the following authorizing entities based on service category: Recipients: Many health care services require prior authorization.
Medication Prior Authorization - Alaska Department of Health and …
WebPrior Authorization Staff. Magellan Clinical Call Center 800-331-4475 – phone 888-603-7696 – fax. Magellan Technical Call Center 800-884-3238. HMS (Healthcare Management Solutions, LLC) 907-644-6800, 800-770-5650.
Alaska - Blue Cross and Blue Shield's Federal Employee Program
WebPrecertification. 1-800-562-1011. Mental Health/Substance Use Disorder Precertification. 1-800-622-1379. Care Management Programs. Asthma. Chronic Obstructive Pulmonary Disease. Congestive Heart Failure. Coronary Artery Disease. Diabetes. 1-888-342-2745. If you are deaf, hard of hearing, or have a speech disability, dial 711 for TTY relay services.
Request Preauthorization: What Services Require it? | BCBSNE
WebAs the member, you are responsible for ensuring a preauthorization request is sent in and approved by Blue Cross and Blue Shield of Nebraska (BCBSNE) before receiving a service or procedure requiring preauthorization.
Prior Authorization (Provider) | BCBSND
WebProvider. Policies & Prior Authorization. Prior Authorization (Provider) Some services, procedures, and equipment require prior authorization before the service is performed. The ordering provider is typically responsible for obtaining prior authorization. Use the search tool below to verify if the service requires prior authorization.
Resources - provider.bcbsal.org
WebLTAC Preadmission Evaluation Form. Therapy Precertification - Blue Advantage. Therapy Precertification - Occupational. Therapy Precertification - Physical. Therapy Precertification - Speech. Psychiatric. Authorization for Disclosure of Mental Health Clinical Information.
Prior Authorizations | Blue Cross and Blue Shield of Louisiana
WebPrescription Drugs. Your doctor must get prior authorization before your health plan may cover certain prescription drugs. Please click the link below to see a list of drugs that require prior authorization. We update this list as new drugs require prior authorization. Benefits may vary by group and individual plans.
Medicare Advantage Prior Authorization | Members | BCBSM
WebIf a prior authorization is required for your medical service, your doctor or health care professional must submit the prior authorization request. Once we get the request and supporting medical records, we will begin the review process. Do you need prior authorization? Services summary.
Prior authorization for requested services - Arkansas Blue Cross
WebPrior authorization for requested services. The primary coverage criteria of certain services must be established through a prior approval or pre-authorization process before they can be performed.
Understanding Prior Authorization - Blue Cross Blue Shield of …
Web4 days ago · What is a Prior Authorization? Prior authorization, sometimes called pre-authorization, is a process where healthcare providers must get approval from health insurance companies before certain medications, procedures, or services can be covered. Prior authorization requests can be approved or denied.
ASHA Advocate: May 24, 2024
Web4 days ago · Blue Cross Blue Shield (BCBS) Federal Employee Program has updated their coverage policies to better specify medical necessity criteria for hearing loss below 40 decibels (dB). Advocacy win! Vermont passed H.766 to keep prior authorization in check and establish timeline guardrails. ASHA and VSHA worked together [PDF] to advocate …
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