Responsibilities and standards news
pSA mandate, phase 1
Responsibilities and standards news
Starting September 23, prism users will only be able to affiliate to groups or facilities that have a pSA. If the group doesn’t have a pSA, users will not be able to access the group’s data until the group assigns a pSA. This means users won’t be able to use prism to submit authorizations, see claims or appeals, etc.
2024 Child CAHPS and CSHCS CAHPS results available
Responsibilities and standards news
The 2024 Child CAHPS and CSHCS CAHPS survey results are now available for providers.
Reminder: You must complete our MOC training by Dec. 31
Responsibilities and standards news
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
Annual pSA renewal process
Responsibilities and standards news
Our annual prism Security Administrator (pSA) renewal period is underway. pSAs will have until Aug. 1 to review and either approve or deny all user affiliations for your group or facility.
May 2025 medical policy updates
Responsibilities and standards news
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in May and approved a series of medical policy updates.
Monthly record retrieval for the 2025 DBM program
Responsibilities and standards news
Our Risk Adjustment team will start monthly email outreach to our Disease Burden Management (DBM) Program providers to collect medical records for targeted DBM members who’ve completed a visit with a provider.
You must complete our DSNP MOC training
Responsibilities and standards news
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
We're collecting records for our Medicare retrospective chart review
Responsibilities and standards news
Our Medicare retrospective chart review kicks off soon
Provider reenrollment for the VFC program closes on April 1
Responsibilities and standards news
Provider reenrollment for the VFC program closes on April 1
February 2025 medical policy updates
Responsibilities and standards news
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in February and approved a series of medical policy updates.
2025 D-SNP MOC training is now available
Responsibilities and standards news
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
Medicaid formulary changes coming Feb. 1, 2025
Responsibilities and standards news
New Medicaid formulary changes coming Feb. 1, 2025