Premera Blue Cross

Overview

Premera Blue Cross is a health insurance provider based in the United States, operating as an independent licensee of the Blue Cross Blue Shield Association. Founded in 1945, the company serves a significant number of members and employs between 1,001 and 5,000 individuals. Premera Blue Cross specializes in offering various health insurance products, including Medicare Advantage plans. The company provides detailed guidelines for referrals, prior authorizations, and care management, emphasizing the role of primary care providers in coordinating care with specialists. For in-network referrals, Premera does not require prior submission, while out-of-network referrals necessitate review and approval. The company also outlines specific services that require prior authorization, including acute hospital admissions, elective surgeries, and certain outpatient procedures. Premera Blue Cross maintains a focus on care management and provides resources such as online tools for submitting authorization requests and accessing necessary forms. The limited document corpus suggests a structured approach to managing healthcare services and member needs within the insurance framework.

Industry