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Creating a provider account

If you are a Priority Health provider, complete these steps to request an online user account. After you submit your request, it may take up to a week for us to verify your information and create your account for you.
  • Required fields are indicated by *
  • Field help is available by clicking

Provider office information

1. *Enter the Practice/Facility Name - the name of the provider practice or facility you represent.

2. Enter the nine-digit practice or facility Tax ID Number.

3. Enter the provider's Priority Health Vendor Number, if known.

4. *Enter the mailing address of the provider or facility in Address Line 1.
Note: This can be a street address or a post office box.

5. Enter any additional address information in Address Line 2.

6. * Enter the name of the City.

7. * If other than the default of Michigan (MI), select the State from the drop-down list box.

8. * Enter the five-digit Zip Code.   Note: Do not enter the zip code extension.

9. Enter the name of an Office Contact/Manager.

User Information

10. *Enter your First Name.

11. *Enter your Last Name.

12. Enter your Job Responsibility or title.

13. *Enter your full E-mail Address, in the following format: yourname@domain.com

14. *Enter the Phone Number of the provider or facility in the four fields provided.
Note: Area code should be entered in the first field. An extension is not required.

15. Enter the Fax Phone Number of the provider or facility in the four fields provided.
Note: Area code should be entered in the first field.

16. *Enter the User Login Name that you want to use to access your account.

  • User names must contain 6 to 12 characters.
  • Use letters and numbers only, no special characters or spaces.

17. *Enter the password that you want to use in the Password field.

  • Passwords must be 8 or more characters, and contain at least one number and one letter.
  • Passwords are case-sensitive, so remember when you use capital letters.

18. *Enter the password a second time in the Password Confirmation field to confirm it's exactly what you want.

Internet Connection Type

19. Select the appropriate Internet Connection Type:

  • Select Dial-up (telephone modem) if you connect to the Internet through a phone line.
  • Select Broadband (DSL/Cable/T1) if you connect to the Internet through a high-speed connection.
  • Select I don't know if you are unsure the type of the Internet connection type.

Tools

20. Select the online tools you want to use.
Note: Several default tools are selected for you. You must choose at least one of the tools.

Subscription E-mail

21. If you would like to receive periodic e-mail newsletters from Priority Health, verify that the Subscription E-mail checkbox is selected. This is the default setting for this checkbox. If you do not want to receive these e-mail newsletters, click to deselect this checkbox.

22. Click CONTINUE.
The Account Request Security Questions page is displayed.

SECURITY QUESTIONS

23. *Select a question from the Question 1 drop-down box.

24. *Enter the answer to the question in the Answer 1 field.

25. *Enter the answer a second time in the Retype Answer 1 field. The answers must match exactly.

26. *Repeat Steps 22 - 24 to select a question and enter the answers in the Question 2 and Question 3 fields.

27. Click CONTINUE.
The Provider Account Request Terms and Conditions of Use page is displayed.

TERMS AND CONDITIONS OF USE

28. Read the Terms and Conditions of Use page carefully.

  • You must accept the terms and conditions before you receive an online account.
  • If you do not agree to abide by the Terms and Conditions of Use, click I DO NOT AGREE. You will be returned to the Priority Health website home page.

If you agree to abide by the Terms and Conditions of Use, click I AGREE.
The Account Request Submission Confirmation page is displayed.

ACCOUNT CONFIRMATION

29. Review your account request.

A Priority Health Web administrators will review your request, and may call your office to verify your information. We will e-mail you to let you know when your account has been approved or denied.


Last modified 05/21/08