Leaving the area, closing your practice, retiring or otherwise terminating your contract
Notifying Priority HealthPriority Health requires written notice, 90 days in advance if you are:
- Terminating a Priority Health participation agreement
- Retiring and/or closing your practice
Failure to give us 90 days notice may result in claims denials or reassignment of members.
Requirements for terminating your contract
- Notify us in writing using the Provider information form
- The provider or the office manager must sign the notice
- The notice must give the reason for termination (ie, retiring, moving out of state)
- If you are a primary care physician, provide in writing the arrangement for transfer of members
Send us a copy of the letter you sent your patients and include:
- Information on where you would like your members transferred, if applicable
- A copy of the Provider information form you sent us, notifying us you were terminating your contract
At least 90 days prior to your retirement or termination of contract with Priority Health, notify us of the change by completing applicable information on our Provider Information form.
Our workflow for getting your questions answered
We work hard to process your requests in a timely manner. Existing provider requests inquiring about provider demographic changes without reimbursement changes will be processed within 18 calendar days. Demographic requests that include reimbursement changes will take 25 calendar days to process.
- We recognize that every request is unique, and not all workflow steps may be required to complete your request. Below is a diagram that was created to show you what step within the process your request is at in our workflow.
- After a request is submitted, you’ll receive an initial email from our Intake team, letting you know we’ve received your request and indicating the workflow step your request is in. You’ll also get an inquiry number associated with the request. Keep the inquiry number in a safe place, because it will help us locate your request if you have questions.
- Following this initial communication, you’ll receive updates from us at each step in the process, letting you know the status of your request, including any action items or additional information we need from you (if applicable).
- Once your request is complete, you’ll receive a final communication from us.
- We have created a new email for you to utilize in the event your request has gone over our processing time frames. The email address is Exceedsprocessingtime@priorityhealth.com. Be sure to include your inquiry number within your status update.
Notify your patients
- You must notify members in writing at least 30 days in advance that you are leaving the Priority Health network
- You will cooperate with extension of care for patients in active treatment, such as pregnant patients past their first trimester based on the provider participation agreement
Physicians or groups who leave the Priority Health network will not be allowed to re-contract with the plan for 12 months, or until the next contract year, whichever is longer.