Our commitments

Our commitments to providers

We honor the physician-patient relationship as the foundation of medical care delivery. Priority Health is also accountable to our members for the quality and cost-effectiveness of the care they receive. As your partner in meeting this goal, it's important to us to have your input and collaborate with you frequently. By working together, we can ensure that patients ― and the health care system ― become healthier.

Here are the commitments that keep Priority Health focused on the right things and guide us in our partnership with you.

1. We will make it as easy as possible to do business with us.

   You can count on us to:
   • Simplify the credentialing process
   • Eliminate, streamline or automate prior authorizations
     
   • Limit material changes in medical and pharmacy policies to twice a year whenever possible
   • Seek your feedback about our performance
     
   • Consider the impact of any changes on your workflow
     

2. We will support your success by improving your access to business and clinical information.

   You can count on us to:
• Deliver robust business information electronically to enable your efficiency
  
• Continuously improve clinical reports to help drive value
  
• Be available to discuss business issues in both ad hoc and regularly scheduled meetings
  
• Develop online tools that support collecting patient fees at point of care

3. We will provide fair, market-based reimbursement for your services.

   You can count on us to:
   • Engage in direct, respectful dialog with you on reimbursement topics
   • Use benchmarking tools that assess the objectivity and fairness of reimbursement models (for example: Medicare RBRVS methods)
   • Provide transparency about our payment rates to physicians
     
   • Promote dialogue with and seek feedback from physicians about reimbursement, incentives and administrative support
   • Provide adequate notice of fee schedule changes

4. We will help improve your ability to provide the highest quality patient-centered care.

   You can count on us to:
   • Support preventive care
     
   • Support your patients' health through integrated disease and case management and behavioral health programs
   • Help primary care practices become patient-centered medical homes through education, opportunities for collaboration and economic support
   • Involve you in developing innovative reimbursement models that drive improved clinical outcomes
   • Engage non-physician providers in the process of team care
   • Collaborate with physicians to improve tools that support comprehensive, evidence-based care at the point of service
   • Drive excellence and efficiency via specialty-focused programs, including centers of excellence
     
   • Align incentives among primary care physicians, specialists and hospitals to promote efficiency and effectiveness
   • Collaborate with physicians, delivery systems and technology resources in implementing affordable and integrated electronic health records
   • Pay for performance and improved outcomes

5. We will collaborate with you to create a stronger health care system for tomorrow.

   You can count on us to:
   • Seek and maintain provider representation on our board and committees
   • Collaborate with providers and government representatives on issues and pending legislation
   • Work to ensure that consistent standards and metrics are applied to the community as a whole