Alert message displaying in error for PriorityMedicare EdgeSM PPO  members in GuidingCare

When entering an authorization request for a PriorityMedicare Edge member in our new authorization tool, GuidingCare, you may experience this alert message in error:

  • "Provider is not contracted with member’s plan. Please submit a request with a contracted provider."

Please bypass the alert and continue to submit your authorization request. Your authorization request will show as pending in GuidingCare until decisioned by our authorization team.