Medicaid APR-DRG rate update effective today
Priority Health has received the new Medicaid APR-DRG rates from the Michigan Department of Health and Human Services earlier than the projected delay date of January 2, 2018.
As a result, claims received on or after November 29, 2017, will be processed at the new rates. As previously communicated (see below), claims paid at the old rate prior to receiving and loading the new rates into our system will not be adjusted.
Please contact the Provider Helpline, 800.942.4765, option 2, or your provider performance specialist, if you have any questions or concerns.
Original news item, 11/02/2017:
Priority Health has learned the Michigan Department of Health and Human Services (MDHHS) will not release and load to CHAMPS the new Medicaid APR-DRG rates until January 2, 2018. Priority Health will have 30 days from that date to load and apply the new rates
Claims will not be adjusted
We will not be making any adjustments for claims paid at the old rate during the 30-day period while we are loading the new rates to our system. Providers may instead choose to hold claims until February to ensure they're processed at the new Medicaid APR-DRG rates.