Submit claims using a clearinghouse or to Premera directly
We currently partner with many EDI clearinghouses and vendors. We can add a new clearinghouse upon review and approval. A clearinghouse acts as a go-between for the provider and the payer (health plan). Using a clearinghouse means you can reach multiple payers through a single vendor.
Submit directly to Premera EDI (not using a clearinghouse)
Before you enroll, you'll need to check with your systemvendor to confirm that your system can send in the HIPAA (x12)-required format. This option is typically used bylarge Facilities, large provider groups and billing services. Please email us for more information.
Submit using a clearinghouse
You can submit electronic claims to Premera EDI using theclearinghouse of your choice or the choice of your software vendor if theclearinghouse is enrolled with us. Please check with your clearinghouseor software vendor on how to submit an electronic claim to Premera EDI. Small offices or individual providerswho do not want to accrue fees from a clearinghouse are encouraged to useOffice Ally free of charge when submitting to Premera EDI. Please emailus for Office Ally pre-enrollmentinformation or visitwww.OfficeAlly.com.
How will I know if my electronic claim was accepted or rejected?
We create an accept/reject report that we share with our direct submitters and clearinghouses. Check with your clearinghouse about receiving reports.
NOTE: Make sure your National Provider Identifier (NPI) issubmitted on your electronic claim. If you are a dual licensed provider,please ensure the appropriate taxonomy code is submitted on your claim. Taxonomy codes will need to be registered on the NPPES website. If you have questions or need toupdate your provider record to include your taxonomy code(s), contactNPPES at 800-465-3203.
