Billing & payment
Here's the information you need to speed the claims and payment process.
How to bill
The basic process for submitting claims for professional charges and facility billing, including diagnosis coding guidelines
Fee schedules
Capitation, injectables, DME and other fees
Clinical editing policy
How Priority Health determines code usage
Code modifiers
Help using modifiers that can cause billing problems
Coordination of Benefits
Handling billing for dual coverage, car accidents, Worker's Comp, and other COB circumstances
Employee billing
Guidelines for protecting the privacy of Priority Health employees and dependents as patients
Procedures & services
How to bill for everything from anesthesia to vision care
Making corrections
How to change and resubmit claims, codes, and payments
Reviews & appeals
Requesting reconsideration for claim/payment/auth denials
Overpayment recovery time limits
Priority Health's policy on recovering overpayments to providers
