Premera Amazon | 9200
Premera Amazon Medical Advice Line | Nurse First
Case Management Smartscript
External DUK
Member Services/Benefit Resources
Screen for CM Referrals
+ info
+ info
External DUK
Case Management
Telehealth Smartscript
Facility Information
Telehealth
Facility Info
Telehealth Options
General account information
+ info
+ info
Rules
Referrals
Referral Smartscript
Account Rules
Client Rules
Referrals/Benefits/Services
+ info
+ info
Member Services and Benefit Resources
Life Insurance - Securian Life
- Life Insurance is managed by Securian Life
- M-F 5a-4p PST | Warm Transfer
Provider Locator - Castlight
- Members can search for in-network providers with cost transparency
- M-F 8a-9p EST
401K - Fidelity
- Members can access & track 401K contributions & returns
- M-F 830a-830p EST | Warm Transfer
Pharmacy - Express Scripts
- Pharmacy benefits managed by Express Scripts
- 24/7 | Warm Transfer
Prescriptions - RX Advance
- Only for members who are covered by Premera Blue Cross and work in DE, FL, KS, or NV
- 24/7
Prior Authorization
- Prior authorizations for certain types of care
- Warm Transfer
Vision - VSP
- Vision coverage provider through VSP
- M-F 5a-6p; SAT 7a-5p; SUN 7a-5p PST | Warm Transfer
Years Ahead
- Offers help for senior care, including a needs assessment
- M-F 5a-5p PST | Warm Transfer
Aetna
- For caller's who are insured by Aetna
- 24/7 | Warm Transfer
Amazon's My HR Live Support
- Handles payroll, PTO, return to work paperwork, paycheck issues, and much more
- 24x7 | Cold Transfer
Benefit Service Center
- Handle COBRA eligibility questions
- M-F 5a-6p PST | Cold Transfer
Childcare - Sittercity
- Offer members variety of caregivers, including pets; can run free background checks
- 8a-7p PST | Warm Transfer
Dental - Delta Dental
- Dental insurance is managed by Delta Dental of Washington
- M-F 7a-5p PST | Warm Transfer
HSA / FSA (Fidelity)
- Amazon's Health Savings Accounts are managed by Fidelity
- M-F 830a-830p EST | Warm Transfer
Kaiser HMO Plan
- For callers insured by Aetna
- 24/7 | Warm Transfer
Premera Amazon Medical Advice Line
REMEMBER: Do NOT provide referrals to callers with a blank member ID (those who are not found on the eligibility file will have no member ID).
Hover each section to view more information
Facility Type
Service Area
Holiday Hours
Hours of Operation
Paging for RX Refills?
No.
Triage Eligibility
Rules
Triage all callers. Search first and if not found add new member. Callers not found in eligibility or added as new (member ID field is blank) should not be offered telehealth or referrals.
ED Authorization Required?
No.
Special Instructions for 911/ED Now Dispo
Yes. Read scripting shown at the top of your care advice page.
On-Call Available?
No.
Video-based treatment option for opioid and alcohol use disorder. Available M-F 9a-6p in all time zones. Coaching available nationwide. Counseling has state restrictions. Medication Assisted Therapy (MAT) available in AK, CA, MI, NJ, WA
Workit Health (BH)
Best for medical issues that need assessment and are appropriate for telehealth. Can access provider via a video visit from a smartphone, computer, tablet.
Doctor on Demand
Best for parents who need virtual support raising children with learning/behavioral challenges.
BH - Rethink
Substance Use Disorder
Behavioral Health
Telehealth
98point6
Brightline (Peds BH)
Boulder Care
If member prefers text, with an option for video. Can access provider via text/chat from a smartphone or other device.
Best for parents/caregivers who need short-duration counselor support for their children; general mental health. Available M-F 8a-9p, ages 18 months - 18 years.
Video-based treatment option for opioid and alcohol recovery. Be aware of state restrictions.
Referral SmartScript
Flip each card to view the referral details
Free benefit for members with diabetes that provides access to diabetes educators, testing supplies, and customized insights 24/7 | Warm Transfer
Members who need assistance with navigating a cancer diagnosis.
Warm Transfer | M-F 6am-6pm PST All other times provide number & hours and advise member to call.
Members struggling or needing assistance with managing difficult health conditions.Warm Transfer M-F 7am-7pm, Sat 9am-12pm PST
For members who need help navigating difficult life changes. AbleTo offers virtual therapy and coaching to manage stress.
Available M-F 8a-8p EST; SAT 10a-6p EST
Behavioral Health
Case Management
Cancer Program
Diabetic Resource
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
AbleTo
Referrals
AccessHope
Livongo
Subtitle
Subtitle
Subtitle
Subtitle
City of Hope
Members looking for a licensed therapist who want text or video sessions Talkspace is available to all Premera members, excluding Medicare Advantage and FEP
Resources for Living provides Amazon’s EAP and offers counseling for challenging situations in 3 sessions that are 100% covered 24/7 | Warm Transfer
Included Health offers services to help match members with providers for second opinions and support managing their conditions 24/7 | Warm Transfer
Expert Medical Guidance
Progyny is a company that offers fertility services to treat a member diagnosed with a fertility issue M-F 9am-6pm EST | Warm Transfer
Infertility Program
EAP
Mental Health
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Progyny
Crisis Resources
Talkspace
Included Health
Subtitle
Subtitle
Subtitle
Subtitle
Pregnant members who could benefit from help navigating maternity and neonatal costs, early intervention, newborn care, and education M-F 7a-8p; SAT 9a-12p PST
Members struggling with substance use disorders M-F 8am-8:30pm; Sa-Su 8am-6pm CST | Warm Transfer
Members who are looking for convenient virtual physical therapy. Offers physical therapy via a video chat consult and personalized exercise programs
Maternity Support
Substance Use
Telehealth
Members looking for a provider M-F 8a-5p PST | Warm Transfer
Provider Finder
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Best Beginnings
Hazelden Betty Ford Foundation
Omada | Physical Therapy
Subtitle
Subtitle
Subtitle
Subtitle
When to Refer to Case Management
- Complex Cases (utilization based)
- Complex medical condition(s) with multiple needs identified (Catastrophic)
- Complex mental health condition(s) with OON Mental Health stay
- Chronic condition with multiple SDOH (social determinants of health) concerns/barriers identified
- Chronic condition management - for members experiencing multiple condition complications
- Inpatient stay >7 days - TOC (Transition of Care)
- Member specifically requests assistance with ongoing clinical concerns or needs.
- Member has health conditions with identified barriers or gaps in care
- Recent Inpatient admission/discharge and at risk for readmission or preventable ED use
- Difficulty finding appropriate care for conditions with assessed current clinical needs
- Other clinical concerns as assessed by the Nurseline clinician that would benefit from follow up from a Premera Case Management Clinician
- Condition/Health Education and Support (Complex Care)
https://utilitypages.carescripts.citrahealth.local/PremeraCaseManagement/CaseManagementCriteriaUtilityPage1.htm
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Transcript
Premera Amazon | 9200
Premera Amazon Medical Advice Line | Nurse First
Case Management Smartscript
External DUK
Member Services/Benefit Resources
Screen for CM Referrals
+ info
+ info
External DUK
Case Management
Telehealth Smartscript
Facility Information
Telehealth
Facility Info
Telehealth Options
General account information
+ info
+ info
Rules
Referrals
Referral Smartscript
Account Rules
Client Rules
Referrals/Benefits/Services
+ info
+ info
Member Services and Benefit Resources
Life Insurance - Securian Life
- Life Insurance is managed by Securian Life
- M-F 5a-4p PST | Warm Transfer
Provider Locator - Castlight- Members can search for in-network providers with cost transparency
- M-F 8a-9p EST
401K - Fidelity- Members can access & track 401K contributions & returns
- M-F 830a-830p EST | Warm Transfer
Pharmacy - Express Scripts- Pharmacy benefits managed by Express Scripts
- 24/7 | Warm Transfer
Prescriptions - RX Advance- Only for members who are covered by Premera Blue Cross and work in DE, FL, KS, or NV
- 24/7
Prior Authorization- Prior authorizations for certain types of care
- Warm Transfer
Vision - VSP- Vision coverage provider through VSP
- M-F 5a-6p; SAT 7a-5p; SUN 7a-5p PST | Warm Transfer
Years AheadAetna
- For caller's who are insured by Aetna
- 24/7 | Warm Transfer
Amazon's My HR Live Support- Handles payroll, PTO, return to work paperwork, paycheck issues, and much more
- 24x7 | Cold Transfer
Benefit Service Center- Handle COBRA eligibility questions
- M-F 5a-6p PST | Cold Transfer
Childcare - Sittercity- Offer members variety of caregivers, including pets; can run free background checks
- 8a-7p PST | Warm Transfer
Dental - Delta Dental- Dental insurance is managed by Delta Dental of Washington
- M-F 7a-5p PST | Warm Transfer
HSA / FSA (Fidelity)- Amazon's Health Savings Accounts are managed by Fidelity
- M-F 830a-830p EST | Warm Transfer
Kaiser HMO PlanPremera Amazon Medical Advice Line
REMEMBER: Do NOT provide referrals to callers with a blank member ID (those who are not found on the eligibility file will have no member ID).
Hover each section to view more information
Facility Type
Service Area
Holiday Hours
Hours of Operation
Paging for RX Refills?
No.
Triage Eligibility
Rules
Triage all callers. Search first and if not found add new member. Callers not found in eligibility or added as new (member ID field is blank) should not be offered telehealth or referrals.
ED Authorization Required?
No.
Special Instructions for 911/ED Now Dispo
Yes. Read scripting shown at the top of your care advice page.
On-Call Available?
No.
Video-based treatment option for opioid and alcohol use disorder. Available M-F 9a-6p in all time zones. Coaching available nationwide. Counseling has state restrictions. Medication Assisted Therapy (MAT) available in AK, CA, MI, NJ, WA
Workit Health (BH)
Best for medical issues that need assessment and are appropriate for telehealth. Can access provider via a video visit from a smartphone, computer, tablet.
Doctor on Demand
Best for parents who need virtual support raising children with learning/behavioral challenges.
BH - Rethink
Substance Use Disorder
Behavioral Health
Telehealth
98point6
Brightline (Peds BH)
Boulder Care
If member prefers text, with an option for video. Can access provider via text/chat from a smartphone or other device.
Best for parents/caregivers who need short-duration counselor support for their children; general mental health. Available M-F 8a-9p, ages 18 months - 18 years.
Video-based treatment option for opioid and alcohol recovery. Be aware of state restrictions.
Referral SmartScript
Flip each card to view the referral details
Free benefit for members with diabetes that provides access to diabetes educators, testing supplies, and customized insights 24/7 | Warm Transfer
Members who need assistance with navigating a cancer diagnosis. Warm Transfer | M-F 6am-6pm PST All other times provide number & hours and advise member to call.
Members struggling or needing assistance with managing difficult health conditions.Warm Transfer M-F 7am-7pm, Sat 9am-12pm PST
For members who need help navigating difficult life changes. AbleTo offers virtual therapy and coaching to manage stress. Available M-F 8a-8p EST; SAT 10a-6p EST
Behavioral Health
Case Management
Cancer Program
Diabetic Resource
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
AbleTo
Referrals
AccessHope
Livongo
Subtitle
Subtitle
Subtitle
Subtitle
City of Hope
Members looking for a licensed therapist who want text or video sessions Talkspace is available to all Premera members, excluding Medicare Advantage and FEP
Resources for Living provides Amazon’s EAP and offers counseling for challenging situations in 3 sessions that are 100% covered 24/7 | Warm Transfer
Included Health offers services to help match members with providers for second opinions and support managing their conditions 24/7 | Warm Transfer
Expert Medical Guidance
Progyny is a company that offers fertility services to treat a member diagnosed with a fertility issue M-F 9am-6pm EST | Warm Transfer
Infertility Program
EAP
Mental Health
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Progyny
Crisis Resources
Talkspace
Included Health
Subtitle
Subtitle
Subtitle
Subtitle
Pregnant members who could benefit from help navigating maternity and neonatal costs, early intervention, newborn care, and education M-F 7a-8p; SAT 9a-12p PST
Members struggling with substance use disorders M-F 8am-8:30pm; Sa-Su 8am-6pm CST | Warm Transfer
Members who are looking for convenient virtual physical therapy. Offers physical therapy via a video chat consult and personalized exercise programs
Maternity Support
Substance Use
Telehealth
Members looking for a provider M-F 8a-5p PST | Warm Transfer
Provider Finder
Title
Title
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Best Beginnings
Hazelden Betty Ford Foundation
Omada | Physical Therapy
Subtitle
Subtitle
Subtitle
Subtitle
When to Refer to Case Management
https://utilitypages.carescripts.citrahealth.local/PremeraCaseManagement/CaseManagementCriteriaUtilityPage1.htm