Patient Advocates for Premera Blue Cross of Washington - Find one today.
Supporting and empowering Premera Blue Cross of Washington patients.
Premera Blue Cross of Washington offers comprehensive coverage options throughout the state, but navigating their complex authorization requirements and appeal process can leave you feeling frustrated and overwhelmed. Your Solace advocate understands Premera's policies inside and out—from securing prior authorizations to appealing denied claims and coordinating care between specialists across Washington's diverse healthcare landscape. They'll handle the paperwork, follow-ups, and persistent phone calls so you can focus on your health instead of battling insurance bureaucracy.
Best of all, most patients pay nothing out of pocket.
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About
Premera Blue Cross is headquartered in Mountlake Terrace, Washington, with additional operations in Spokane, and serves as one of the largest health insurers in the Pacific Northwest. With approximately 3,000 employees and 1.5 million subscribers across its affiliated companies, Premera offers a range of coverage options for individuals, families, and employers throughout Washington state. Their provider network varies based on plan type, with individual plans utilizing the "Legacy and Dental Select" network, while small group plans may use different networks such as "AK Heritage" or "AK Heritage Plus." Premera provides access to telehealth services, a 24-hour nurse line, and mobile app tools to help members access care and information. However, members often face challenges with their prior authorization requirements, which typically take 5-7 business days for standard processing, and a multi-stage appeal process that can be difficult to navigate, particularly for those needing specialized care or facing claim denials.
What problems can a Premera Blue Cross of Washington patient advocate help you with?
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Get the clarity you need to make sense of your care and take charge of your health.
We’ll make the calls (and the callbacks) so you can spend more time doing what you love.
Keep your care affordable with lower medical bills and access to local financial help.
Advocates review coverage, handle preauthorizations, and even help with appeals.
Stay on top of the cutting-edge treatment options and leave no stone unturned.
Advocates coordinate your care team so your health never falls through the cracks.
Get the tools and answers you need to make informed decisions about your care.
Advocates help you overcome your healthcare hurdles—no matter how big they might be.
Solace has helped over 14,000 patients and families
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04/01/2024
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08/07/2024
Joan H.
05/01/2024
Stephen I.
04/27/2024
Jonathan J.
06/05/2024
Anne J.
07/27/2024
Premera Blue Cross of Washington Appeals with a Patient Advocate
Premera's appeal process involves multiple stages that can be challenging to navigate alone. For standard appeals, you or your representative need to submit a written request using Premera's member appeal form or a letter to their Seattle office. Your Solace advocate knows how to prepare comprehensive appeals that include all necessary documentation, proper coding references, and address Premera's specific coverage criteria. They'll track deadlines, follow up persistently, and guide you through each stage from Level 1 appeal to external review if necessary.
When facing a Premera denial, your advocate will immediately identify whether the issue stems from missing documentation, coding errors, network limitations, or medical necessity determinations. They'll work with your healthcare providers to gather supporting evidence and may coordinate peer-to-peer reviews between your doctor and Premera's medical directors. As one advocate from Premera's clinical review team recommends, "Be an advocate for your own health" and work with your doctor to get the appeal right—your Solace advocate serves as that dedicated health advocate, ensuring small details aren't overlooked that could make the difference in your appeal's success. For urgent situations requiring expedited review, they know exactly what documentation is needed to demonstrate medical necessity and secure faster response times.
Washington's diverse healthcare landscape, from urban centers to rural communities, creates varying challenges that a Solace advocate's expertise is perfectly positioned to help you overcome.
The Solace care team model
With Solace, you get both a patient advocate and a supporting physician, which we refer to as your “care team”.
Your advocate will be there to manage the day to day aspects of your care: coordinating with doctors, researching potential solutions and communicating updates to you.
Your supporting physician can unlock resources for you and your advocate that might otherwise be out of reach.
We’ve Got Answers
Still unsure how an advocate can help? Explore these answers to the questions we’re asked the most.
How are Solace advocates qualified to help?
Advocates on Solace are experienced physicians, nurses, pharmacists, and other healthcare professionals from a wide range of backgrounds. 98% of Solace patients report better healthcare outcomes after working with an advocate.
What else can a Solace advocate help me with?
What can a Solace advocate not do?
We know our advocates sound like miracle workers, but they have limits. They can’t prescribe medications or diagnose an illness, for instance. They can’t replace your doctor, but they can break down the barriers standing between you and the quality care you deserve.