We heard you, and we've made some exciting changes to our online provider portal to help you work with us faster and easier. As part of our commitment to reducing your hold time when you call us, we are giving you more of the information you need at your fingertips.

New and easier to understand benefit information in Member Inquiry

Member Inquiry is your tool to look up a member's contract, coverage, deductible and benefit information. Get started by clicking on Member Inquiry and searching for a member.

New! Vision benefits for Medicaid available

See the most recent dates of service for vision exams and original and replacement frames and lenses for Medicaid members.

Track your patients' visit limits for rehab and home health care

Medicare member limits are shown as a dollar amount. Limits for all other members are shown based on number of visits. Many plans do not have home health care limits, so no limit will show. As plans renew, we will start showing a count of how many visits were tracked. This will help you when a member's plan requires authorization after a certain number of visits.

Medicare sample

Commercial sample

Easier to understand contraceptive contracts

When an eligible organization opts out of contraceptive coverage for their employees, Priority Health covers some generic contraceptives for these members under a separate contract and member ID number. The contraceptive contracts are now clearly labeled and are listed below each member's medical benefit contract number.

Chiropractic service benefits clarified

When you search for additional benefit information, we have made chiropractic and rehabilitative medicine services easier to understand. When a member has a chiropractic rider, it will appear under Chiropractic. When they have a visit limit that's combined with PT and OT visits, it will appear under Rehabilitative Medicine Services.

 

Go to Member Inquiry now.

Auth Inquiry is now easier to use

We've added the procedure code to our Auth Inquiry tool so you can easily see what procedure(s) were approved for your patient. It's also easier to find Auth Inquiry. Just go to the Provider Center. You'll see a new "card" for Auth Inquiry there. Click the link, search for the member or authorization number, and scroll to see the new procedure code displayed.

Go to Auth Inquiry now.

More improvements coming soon

We're working on even more enhancements based on your feedback. Check provider news for updates later this spring.