Provider Manual
- Appeal a denied claim
- Approved Drug List
- Authorizations
- Check claim status
- Check patient eligibility
- compliance policy
- Correct a claim
- Request a drug authorization
- File a claim
- Participate with Priority Health
- See medical policies
- Find provider forms
- Cigna Strategic Alliance
- Clinical resources
- Information on COVID-19 for Providers
- Medication Therapy Management (MTM) Program
- Specialty pharmacy process
- Provider fee schedules
- Formulary updates
- Provider incentives program
- Provider Roster App (PRA)
- Request an exception to the formulary
- Contact Priority Health provider services
- Set up electronic funds transfers
- Set up electronic claims / RAs
Provider news
July 27 GuidingCare tips: InterQual SmartSheets and messages
July 15 Duplicate RAs in Filemart, paper checks slightly delayed this week
July 13 Legacy THC providers must wrap up claims, appeals by Dec. 31, 2022
July 12 New clinical edits for facility claims going into effect on Sept. 15, 2022
July 12 Medicaid Claim Edit 21007 rejection issue resolved
July 11 Aligning APCD data with our value-based programs has never been easier
June 30 Ensuring quick and accurate Elective Inpatient Admissions authorization reviews
June 30 New clinical edits announced in June 2022
June 21 Online peer-to-peer requests, 2022 InterQual criteria coming to GuidingCare
