Out-of-network provider surprise billing payment disputes

According to Michigan law, out-of-network providers aren't allowed to send patients surprise bills. Surprise billing, or balance billing, has never been allowed for participating providers.

Surprise billing happens primarily when a patient receives care at in-network facility but the provider may not be contracted with the insurance carrier and is considered an out-of-network provider.

See our surprise billing webpage for details on the information out-of-network providers are required to give non-emergency patients.

Surprise billing payment disputes

If an out-of-network provider disagrees with how they’ve been reimbursed related to surprise billing, they have the right to initiate a 30-day open negotiation period.

To initiate an open negotiation period, send an email to provider.services@priorityhealth.com including your name, phone number and message. Be sure to attach the required open negotiation letter, including a description of the item(s) or service(s), claim #, provider name and NPI along with dates of service.