HRA system upgrades effective Apr. 1

HRA system upgrades mean faster payments

PriorityHRA^SM just got a little easier. We've been working to improve the way our health reimbursement arrangements (HRA) are administered, and we're excited about the improvements you will notice beginning April 1, 2008.

Quick, automatic reimbursements
We'll continue to automatically send medical payments and HRA reimbursements to providers. Our new enhancements will eliminate the one week lag between the processing of the medical plan portion and the HRA portion. Additionally, the HRA and medical payment will be associated to the same claim ID. This will allow you to quickly identify remaining patient liability for faster balance billing.

Paper R/As
The remittance advices (R/A) will have a new reason code for HRA members:

• The Medical R/A will show "HRM: Process as primary, forwarded to additional payer(s) Priority Health HRA." You will receive the HRA payment within 3 to 5 business days from the Medical R/A. 
• The HRA R/A will have the reason code "HRO:  HRA member liability from prior claim considered for HRA benefit." Member may still owe member liability for this claim.  After you receive the HRA R/A you may then bill the member the member liability.

Online R/As at priorityhealth.com
The online R/As on the Claims Inquiry page will take on a new and improved look too! When searching for claim detail on a specific member you will see the Medical and HRA claim payment detail within the same view. The Provider Remittance Summary will also provide detail for both (medical and HRA) checks. And, the claim number will be the same for both plans. 

We've added new columns as well – Patient Cost, HRA Paid and Patient Pays. In the Patient Cost column we are providing additional information to help you breakdown the members liability portion into four categories – deductible, coinsurance, copay and disallowed.

Our claim data is updated nightly, which means you'll be able to see nearly real-time claim data for your HRA patients.  

Questions
If you have any questions contact your field service representative directly or through the Provider Helpline at 616 942-4765 or 800 942-4765.