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
December 13: Prior authorization changes coming for diabetic insulin supplies for Medicare members
December 13: Reminder: Authorizations for some varicose vein procedures will be required starting Jan. 1, 2025
December 5: Final 2025 PCP Incentive Program (PIP) manual and supporting resources are now available
December 4: Reminder: The best way for practices to communicate with us is through prism
December 4: Reminder: Credentialing and enrollment status updates are available in prism
December 4: New HMA landing page available for our TPA product launching January 1
November 20: Reminder: You must complete our 15-minute, CMS-required D-SNP Model of Care training
November 20: Reminder: Photos are required for home health wound care authorizations after 60 days
November 20: Peer-to-peer policy update cancelled
November 20: November 2024 medical policy updates
November 20: Southeast Michigan networks clarification (narrow vs. tiered networks)