Provider Manual
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Recent news
(October 20) Drug recall: Nature Throid® and WP Thyroid®
(October 15) Reminder – Submit post-claim appeals and medical records through the Claims tool
(October 6) Reminder: DSNP Model of Care training due Dec. 31, 2020
(October 2) ePA for pharmacy now available through the Surescripts portal
(October 1) 2021 PIP preliminary manual
(September 29) Claims processing for providers at temporary locations for COVID-19 ends Sept. 30
(September 22) GuidingCare tips: InterQual® and expedited authorization requests
(September 21) Do you provide acupuncture services? Let us know.
(September 16) GuidingCare reminder: no longer accepting in-network authorization faxes and tips for quicker authorization processing
September 13) Alert message displaying in error for PriorityMedicare Edge PPO members in GuidingCare
(September 8) 2020 AHA claims submission deadline is Feb. 28, 2021
(September 4) New authorization tool launches September 14
(September 3) Reminder: Cost Estimator available to all providers
(September 3) MDHHS announces $25M PPE grant
(September 2) Mandatory blood lead testing for children covered under Medicaid and WIC
(August 28) Congratulations to the 2020 Priority Health Quality Award recipients
(August 14) Non-Medicare outpatient services moving to 90-day window for retro authorizations
(August 13) FDA recalling select desmopressin nasal spray products
(August 12) Coming August 31: ePA for pharmacy
(August 5) Some COVID-19 test claims denied, to be reprocessed
(August 4) Reminder: Complete your PriorityMedicare D-SNP Model of Care training
(July 31) New mental wellness tool, myStrength, available to all members
(July 31) Medicaid Health Plans transitioning to Preferred Drug List on Oct. 1, 2020
(July 30) Billing reminders for providers treating Qualified Medicare Beneficiaries
(July 29) Authorization is no longer required for in-network hospice services
(July 29) Register today for our new authorization tool webinar training
(July 17) Metformin ER recall
(July 14) Updating medical policy criteria
(July 13) Transitioning to InterQual 2020
(July 8) COVID-19 update for providers