Changes to staff/address/phone

Reporting most changes

To notify Priority Health of changes in your address, staff, tax ID number, or if you are accepting or closing to new patients, follow these steps:

1. 60 days or more before the change takes effect, complete and print a Demographic Change form.
   Provider Demographic Change Form (515KB PDF)
2. Fax or mail the form to Priority Health at the address/fax number on the form.

Reporting retirement/termination

At least 90 days prior to your retirement or termination of contract with Priority Health, send us a letter signed by the contract holder notifying us of the change.

Where to send changes

Address all correspondence to Provider Services addresses.