Provider website pages moving outside of login

Updated Jan. 17, 2019:  Starting in December, we began moving Provider Center pages from the logged-in Provider Center to the Provider Out-of-Network Guide, so you don't have to log in to see them. We renamed the Out-of-Network Guide the Provider Manual. The process of moving pages will continue throughout January.

Changes you'll see when you log in

When you log in to your Priority Health provider account, you'll still go to the Provider Center. There, you'll still see links directly to your online tools. However, some of the "cards" you see will disappear as those pages are moved to the Provider Manual outside of login.

To access information outside of login in the Provider Manual, you can:

  • On the Provider Center page, click the "card" labelled Provider Manual 
  • On any provider page, scroll to the bottom of the page and click the links in the footer to go directly to the Authorizations, Billing & payment, Plans & benefits etc. sections.

To go back to the logged-in Provider Center, you can::

  • Click the "Hello, Yourname" dropdown at the top of the page and choose Provider Center.
  • Scroll to the bottom of any provider page and click a tool name or section that's still in the Provider Center.

Changes to the Provider Manual

Without logging in, you see the new Provider Manual (the former Provider Out-of-Network Guide). It looks very similar to the Provider Center you see when you log in, with a "card" quick link to the sections in the Manual. More cards will appear or change as we move content out from behind login. 

The footer has changed to be the same footer you see when logged in. If you click a link in the footer for a tool or to a section that's still behind login, you'll get a screen asking you to log in to see that content.

Drug-specific auth forms, billing info has moved

One of the biggest changes is that we have moved all the drug-specific pages outside of both the Provider Center AND the Provider Manual. It's now under the Drug authorizations page that's used by all Priority Health providers, members, employers, even agents. This is the page that our Approved Drug List tool links to for more information about authorizations and other requirements.

Now, instead of a list of drugs with links to the authorization forms right on that page, you'll need to click on a drug name and go to that specific drug page. This is because we have drugs that don't have specific authorization forms, and providers were assuming that no authorization was necessary. When you go to the drug-specifc page now you'll find the authorization forms, but you'll also find coverage and billing information for injectables, and other information about that drug.

Update your bookmarks/favorites

If you have bookmarked pages in your internet browser favorites, you'll need to delete those bookmarks and create new ones.

Schedule for moving pages to the Provider Manual

Week ending

Sections moving during this week

Dec. 21 Provider news & education; Contact us
Jan. 4 Clinical resources; Drugs; Plans & benefits
Jan. 11 Billing & payment (except the fee schedules); Reviews & appeals; provider forms
Jan. 18 Requirements & responsibilities
Jan. 25 Procedures & services, including Behavioral Health, Medical/surgical, Preventive,Vision, and Services not covered
Feb. 1 Authorizations; Your online account

Again, the interactive provider tools still require login. The fee schedules, incentive programs, and the health reporting sections in the Data exchange section also remain behind login.