How to submit your request
- Log into your prism account. Make sure you’re logged in as the group or facility the claim was paid under.
- Under the Claims tab click Medical Claims.
- Find the claim in question on the claims listing page. You can use the search bar in prism to enter your Claim ID or any element on the claims list page to filter your claims. When you find the right claim, click on the Claim ID link.
- On the Claims Detail page, click Contact Us About This Claim. This will open a new window.
- Choose “Other related claims questions" in the “What is your message about” drop-down menu.
- Complete all fields, attach any documentation, write us a message and click Send.
What happens after you click send?
Your inquiry will appear in the General Requests section of prism after submission. We’ll respond to your inquiry within 15 calendar days. To see our response in prism, go to General Requests, open the inquiry and look at the Comments section. You’ll receive an automated email notification when a comment has been entered on your inquiry.
If your inquiry requires investigation by another department, we'll notify you via comments within 15 calendar days.
If you haven’t received a response within 15 calendar days, email us at exceedsprocessingtime@priorityhealth.com and include your inquiry number.
If you're not satisfied with the outcome of the informal claim review, you can file a Level I appeal.
Itemized Bill Reviews (IBR)
Follow this Informal Claim Review process to submit questions related to Itemized Bill Reviews (IBR). After you submit your inquiry, we’ll follow up with a detailed breakdown of the review outcome, routing any further questions to our Payment Integrity team.