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
March 11: We're reprocessing select doula claims due to a fee schedule error
March 10: Changes in TREMFYA coverage coming Apr. 1, 2025
March 5: New rewards supporting maternal care for your Priority Health Medicaid patients
March 5: We're collecting medical records for our Medicare retrospective review
March 5: Get our 2025 member outreach calendar
March 5: We're resolving some Medicaid claims rejecting incorrectly for missing or invalid date of death
February 25: Register now for our March 20 Medicare & Medicaid quality webinar
February 25: Pontiac General Hospital is no longer in the Priority Health network
February 19: New and updated billing policies are available
February 19: February 2025 medical policy updates
