Priority Health plans may include a health reimbursement arrangement (HRA). Providers should not collect estimated deductible or coinsurance payments from Priority Health members with an HRA in advance of billing Priority Health. Instead, collect any required copays at the time of service and submit claims for other costs of care to Priority Health first. Priority Health will pay providers directly from the member's HRA for eligible expenses.
What’s an HRA?
An HRA is an employer-owned and funded account that helps members pay for eligible healthcare expenses. Priority Health offers employer groups PriorityHRA as an add-on to standard plans. PriorityHRA may pay for a member's medical deductible, medical coinsurance or both, and employers can determine who pays first—the member or the HRA.
How are coinsurance payments paid for PriorityHRA members?
Priority Health uses a fully integrated system to simplify the administration of claims processing and reimburses eligible expenses directly to providers. Priority Health uses the member’s HRA funds until the HRA is exhausted. This process eliminates paperwork and promotes accurate billing, preventing unnecessary upfront member payments and ensuring providers are paid accurately.
If the member has a remaining balance due to the provider, you will be notified so you can bill them, and the member will be informed through the Explanation of Benefits (EOB).
How are PriorityHRA members identified?
Members with PriorityHRA will have “+ HRA” in the Health plan field of their member ID card.
Providers can also use Member Inquiry in prism to identify PriorityHRA members. Between the Medical Benefits dropdown and the Deductibles information, PriorityHRA members will have an HRA Limits section, which will include all details of the member’s HRA account, including funds used.
The new Provider Portal launching January 1 will also have HRA information in Member Inquiry.