Update to secondary claims process effective Mar. 1, 2023

We’re always striving to drive visible value for both our members and our providers. With this in mind, we’re making an update to the claims submission process for members with coverage under more than one Priority Health plan.

This change will affect all providers across commercial, individual and Medicare plans.

What’s changing?

Starting Mar. 1, 2023, our teams will no longer automatically process a claim against both a member’s primary and secondary coverage plan. Rather, when a provider submits a claim for a member covered under more than one of our plans, we’ll process the claim against the primary coverage and issue an explanation of benefits (EOB). The provider can then submit a secondary claim if applicable.

Why are we making this change?

Most providers already submit secondary claims. With our current internal process, this is causing duplication.