Premera Supports Provider Partners with Six New Availity Features

Premera recently released six new features into the Availity Essentials provider portal. The new features help providers manage administrative tasks more efficiently and focus on delivering high-quality care to our members.

The new functions were identified and validated in collaboration with our provider partners.

“The collaborative approach we took ensures that the tools we release genuinely meet providers’ needs and expectations. Ultimately, we want to improve our relationships and current perception with providers, reduce their administrative burden, and minimize their need to pick up the phone and call us,” said Jessi Spytek, strategic programs director.

Here are the new features:

1. Improved claim denial reasons – Provides clear reasons why a claim was denied, so providers don’t have to call for explanations
2. Claim attachments – Adds a new button to send extra information to support the processing of a claim
3. Claim corrections – Lets providers fix claims that Premera has already accepted
4. Deluxe remittance viewer – Lets providers see all claims linked to a specific payment explanation
5. Enhanced claim status – Helps providers quickly see if a claim is denied, approved/paid, or needs action
6. Commercial standard fee schedules – Providers no longer need to contact Premera for a copy

A new feature for the second pass editor went live in November. This feature lets providers see clear policy and reasons for claims that have a second pass edit applied within Availity.

Positive provider feedback

Senior Provider Experience Strategist Anita Hegwald demonstrated the new Availity standard fee schedule tool for a Spokane provider this month. The provider told Anita that she loved the new feature and how easy it is to use. The provider also shared “Now when a patient asks how much a service is going to cost, we can easily provide them with Premera’s current fee schedule rate.”  Before the tool was launched providers had no way of knowing if the last fee schedule they had on file was the most current version.

Consistently improving our Availity tools helps meet providers’ needs:

• Gives providers a single source of tools, removing the guess work of learning multiple health plan platforms
• Offers quick online self-service rather than calling
• Helps out-of-area providers caring for our members
• Improves provider satisfaction, especially those who are also Premera plan members