Leaving the area, closing your practice, retiring or otherwise terminating your contract

Notifying Priority Health

We require written notice 90 days in advance if you're:
  • 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.

Reporting retirement / termination

To notify us, at least 90 days prior to your retirement or termination of your contract with us, you’ll need to:

  1. Log into your prism account
  2. Click the Enrollments & Changes tab and then on Change Individual Provider or Organization
  3. Select the appropriate dropdown menu item for your request
  4. Download, complete and upload the required paperwork*
  5. Fill out all text fields
  6. Click Submit

*Be sure to include the following:

  • 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 

Check the status of your request

Once you submit your request, our team will receive an inquiry. You can check the status of your request and view comments from our team any time in prism by clicking on Enrollments & Changes and selecting the Inquiry ID. When you request is completed, you'll receive a comment from our team. Any time our team posts a comment, you'll receive an email notification. 

Notify your patients

  • You must notify members in writing at least 30 days in advance that you are leaving our network
  • You'll cooperate with extension of care for patients in active treatment, such as pregnant patients past their first trimester based on the provider participation agreement
  • Send us a copy of the letter you sent your patients and include the inquiry number associated with the termination request

Re-contracting limitation

Physicians or groups who leave our network won't be allowed to re-contract with the plan for 12 months, or until the next contract year, whichever is longer.