Clear Coverage™ discharge process changes effective 09/05/2017

Effective September 5, 2017, Priority Health will no longer call hospitals to obtain discharge dates.

When entering discharge dates in Clear Coverage:

  • You must enter the discharge date within 5 days of discharge; this is critical to ensure prompt adjudication of the claim and subsequent payment.
  • If the authorization remains open with no activity such as a CSR (Continued Stay Review) or a discharge within 7 days, Priority Health will close the authorization with discharge date to reflect the last covered day.
  • If the last covered day does not match the discharge date, the claim will not pay.

See on-demand training, including a video, training guide and FAQ for Clear Coverage™ in the Authorizations section > Auth Request help.