Provider webinars

Page last updated on: 6/11/25

Spend your lunch hour with us in these educational webinars, which we produce several times a year to connect you with Priority Health experts and help your practice maximize its effectiveness. The webinars will cover a variety of topics of timely relevance. We send invitations and registration information via email, newsletter, news items and prism notifications.

You can always watch past webinars on demand after the date of the event. Use the same link that you did for registration to access the webinar on-demand.

We also now have a library of VOA Modules, short on-demand content about topics of enduring relevance.

2025 webinars 

Click the links below to register for each webinar. Specific subtopics will be announced a month prior to each webinar. Find these agendas by clicking "2025" below to expand that section and find webinars listed by date, most recent first. 

 

 Topic

Date

Billing & coding

Including content on prism, credentialing/enrollment, authorizations and general tips

Medicare & Medicaid quality

Including content on behavioral health, our PCP Incentive Program, Disease Burden Management and HEDIS measures

Product

Both reminders and updates

Pharmacy

Including formulary changes and related product change reminders

Incentive programs

Including PIP and DBM

Provider manual 2025 webinars accordion

January 30: billing & coding

  • Navigating our Provider Manual & helpful resources
  • Understand how your claim processed and why, right in prism
  • Most common clinical edits we see applied to claims
  • Asking a question about or disputing a clinical edit
  • Submitting corrected claims
  • 2025 telehealth billing updates

February 20: product tips & reminders

  • Finding Priority Health product information
  • Servicing HMA members with Priority Health's TPA product
  • Seeing Cigna members in Michigan through Priority Health's Strategic Alliance
  • Understanding HIDE SNP, a new integrated plan replacing D-SNP
  • Reviewing Medicare benefits, including Galleri, Carallel and Extra Help

March 20: Medicare & Medicaid quality

  • Medicare and Medicaid member supplemental benefits
  • Medicare and Medicaid member incentives, including an overview of our new Medicaid maternal health incentive
  • Information on our 2025 CAHPS and HOS campaigns 

April 17: billing & coding (with credentialing & enrollment tips)

  • Credentialing and enrollment tips: How to set up a new group, add a provider to an existing group and update provider information
  • Clinical edits and misused modifiers: The most commonly seen clinical edits and misused modifiers and how to correct these issues and bill appropriately
  • Behavioral health billing: Ensuring your staff is credentialed appropriately, getting authorizations when necessary, coding diagnoses to the highest specificity and more
  • Ambulance billing: Tips and reminders for successful ambulance billing

May 15: quality & behavioral health

  • The behavioral health team at Priority Health: Who we are and what we do, Teladoc Health Mental Health and resources for providers and members
  • Medicare quality: The Health Outcomes Survey (HOS), 2025 new Star rating measures and medication adherence reports
  • Medicaid quality: The Priority Health Medicaid Health Journal, pediatric quality updates and maternal health updates

June 12: mid-year pharmacy & product updates

Pharmacy updates:

  • June 1 Stelara coverage changes
  • July 1 formulary changes
  • An overview of our process for submitting requests for drug coverage authorizations

Product updates:

  • Ayble: a virtual digestive health support platform
  • Virta: digital resources for type 2 diabetes management and sustainable weight loss
  • In lieu of services (ILOS): food delivery services for some Medicaid members

June 26: supplemental data submission

  • Understanding our supplemental data strategy and available submission methods
  • Using data feeds (i.e., MiHIN, APS, HL7 and EPP) to submit supplemental data, including how to appropriately set up an HL7 / APS data feed
  • Submitting medical records through SharePoint, including updated file naming conventions to support smoother record processing for gap closure
  • Signing up for Cognizant’s Provider Registry, including why it may be useful for your practices’ workflow and how to navigate the tool

July 10: billing & coding webinar

  • Clinical edits we commonly see applied to claims and coding tips to avoid them
  • Modifiers that are commonly misused and how to use them appropriately
  • Medically Unlikely Edits (MUE) denials and how to interpret adjustment indicators for each HCPCS/CPT code
  • Unlisted codes billing and how to get them processed on the first submission
  • Corrected claims and how to submit them
  • prism navigation and resources to help you find what you need and get your questions answered

February 2024 (52 min.)

  • prism inquiry tips: When and how to reach out to our team
  • Community Care Management (CCM): Program purpose and highlights, member eligibility criteria, CCM provider partners, new substance use pilot program, referral process and provider resources
  • New updates to the member Cost Estimator tool: How to access the Cost Estimator tool in prism, provider FAQs, tips on navigating the tool and provider resources
  • PriorityBABY: Program details, objectives and how to share information with patients.
  • Medicare and Medicaid quality updates: Medicare annual CAHPS survey updates, 2024 priorities (pharmacy medication adherence, care coordination measures, ECDS and Health Equity) and pregnancy management for Medicaid members
  • Disease burden management program updates: How ACNs can earn incentives, member qualifications for DBM and provider resources
  • 2024 PCP incentive program updates: 2024 measure updates and our Digital First Strategy
  • Patient discharge: the new process in prism: How to discharge patients from their assigned PCP in Member Inquiry

April 2024 (54 min.)

  • Billing and coding policies
  • Multiple same-day procedure (MSD) billing
  • Durable medical equipment (DME) billing
  • Doula billing
  • Q11 claim denials
  • Seeing Cigna members in Michigan
  • How to report additional diagnoses on claims
  • Hierarchical condition categories (HCC) coding for the disease burden management (DBM) program

June 2024 (65 min.)

  • prism: new prism communications tools and prism Security Administrator (pSA) renewals
  • Pharmacy: July 1 formulary changes and information on a new member discount program: PriceMyMeds
  • Behavioral health: credentialing tips and virtual member support with Teladoc Mental Health
  • Quality: medication adherence reports and the Medicare Health Outcomes Survey (HOS)

2025 PIP program overview (23 min.)

  • A new Access to Care measure, supporting increased efforts to engage your hardest to reach patients
  • Care Management monthly PMPM payment, replacing focus measure pre-payments
  • Preventive, chronic disease management and Medicare 5-Star measures maintained from 2024
  • New disparity measures, addressing differences and/or gaps in health care across racial, ethnic and socio-economic groups

Q4 quality campaigns (27 min.)

  • Closing patient care gaps through at-home screenings
  • Medicare/Medicaid member outreach
  • Medicare/Medicaid member incentives 
  • Our annual patient care and coordination survey

2025 product updates (50 min.)

  • Commercial group product updates, including the HMA third-party administrator (TPA) product, a new narrow network product called PriorityIntegra and a musculoskeletal centers of excellence rider
  • Individual product updates and reminders about MyPriority narrow network plans
  • Medicare product and benefit updates
  • Medicaid rebid impacts

2025 Disease Burden Management (DBM) program (20 min.)

  • Elements from the 2024 DBM program that will carry over into 2025
  • What's changing in 2025, including 2 new program incentives
  • How to be successful in risk adjustment and the 2025 DBM program

2025 Medicare & Medicaid quality updates (26 min.)

  • An overview of our 2024 quality initiatives
  • A look into quality's 2025 HEDIS areas of focus

January 1 formulary changes (29 min.)

  • 2025 commercial and individual formulary changes
  • 2025 Medicare Part D formulary changes
  • Impacts of the Inflation Reduction Act (IRA) in 2025
  • An overview of the 2025 Medicare Prescription Payment Plan (M3P)

December 2023 (44 min.)

  • prism security: The pSA (prism Security Administrator) process for TPAs (third-party administrators), how practices can determine if their affiliation has a pSA and how to assign PSAs in prism 
  • Pharmacy updates: Formulary changes, coverage changes for Humira and its biosimilars, RSV vaccine coverage updates, pharmacy specialty network updates and continuous glucose monitor core benefit changes 
  • Medicaid quality updates: Information on pre-exposure prophylaxis, chronic kidney disease, doulas, lead screenings in children and vaccines for children 
  • prism inquiry tips: Submitting inquiries using the Clinical Edits dropdown vs. the Other Related Claims dropdown in prism and submitting inquiries for issues impacting more than 10 claims 

October 2023 (48 min.)

  • prism security updates: Information on prism security administrators (pSAs) and how to assign one
  • Behavioral health updates: information on community care management (CCM) and our self-help mental wellness tool
  • Medicare quality updates: Q4 member campaigns, 90-day prescription refills and 2024 CMS star ratings updates
  • 2024 Priority Health product updates: Updates on group commercial, individual, Medicare Advantage and D-SNP products
  • A 2024 PIP program overview: Updates, information about our digital first strategy and a sneak preview of our preliminary 2024 PIP Manual

August 2023 (38 min.)

  • Behavioral health billing tips: Appeal submissions deadlines, limited license providers, changing locations and more
  • Coding tips: How to use our Edits Checker tool effectively, virtual care billing, how to submit clinical edits questions and where in prism to review front-end rejections
  • Appeals tips: An overview of pre- vs. post-claim appeals, what to include with your appeal and working with third-party appeal companies
  • Pre-service organization determinations: When you need them and how to request them

June 2023 (48 min.)

  • July 1 formulary changes: Drug and continuous glucose monitor changes
  • PHE ending: How the end of the Public Health Emergency (PHE) impacted member coverage and virtual care billing
  • GuidingCare: Updates to our prior authorization portal, including new helpful pop-ups
  • Medicaid quality updates: Provider resources, Health Risk Assessment (HRA) incentive, lead screenings and immunizations
  • Medicare quality updates: Health Outcome Survey (HOS), annual physical exams, member rewards, tips for keeping members adherent and more

April 2023 (25 min.)

  • Top 5 denial reasons of 2023 so far and how to avoid them
  • How to get your Priority Health questions answered and how to submit your inquiries in prism, with real life examples
  • Fee schedules and how to find them
  • Appeals tips for non-contracted Medicare providers
  • Behavioral health credentialing and enrollment tips

February 2023 (32 min.)

This webinar is a great resource if you’re new to the Priority Health network or need a refresher on the online tools and resources available to help you work with us.

We show you how to:

  • Get important news and updates
  • Find the most requested information on our website
  • Access training videos, news archives and more

December 2022 (35 min.)

  • January 2023 formulary changes
  • 2023 E/M coding changes
  • Provider tool spotlight: (1) Best practices for credentialing, billing, payments and prism (2) Top reasons for claims denials and how to avoid them

October 2022 (60 min.)

  • New products/updates: Regulatory product updates and new, innovative products focused on integrated benefit navigation and accessible care coordination
  • Medicare quality and 2023 products: End-of-year quality pushes and new Medicare products
  • 2023 PIP updates: Learn about the 2023 program

August 2022 (40 min.)

  • 2021 Quality Awards: Congratulating our winners
  • prism spotlight: Review how to submit claims and appeals through prism to increase response time
  • Medicare quality: 2022 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results
  • Behavioral health: Resources to support your patients during Suicide Prevention Awareness Month
  • GuidingCare upgrade: Addition of peer-to-peer medical review requests through the authorization portal and the update to InterQual® 2022 on Aug. 22, 2022
  • Value-based programs: Key PCP Incentive Program (PIP) updates and deadlines

June 2022 (30 min.)

  • Pharmacy: July 2022 formulary changes
  • Quality: Statin Star measures: Tips for keeping patients adherent, monthly adherence reports to get the most from our PCP Incentive Program and ICD-10 codes for intolerance
  • Risk adjustment: Coding and documentation for depression/major depressive disorder, morbid obesity and social determinants of health, to help you manage better outcomes for your patients and earn incentive dollars through our value-based programs
  • Member programs: PriorityMOM update

April 2022 (30 min.)

  • Coding and billing tips for Medicare & Medicaid
  • Value-based program updates, including PCP Incentive Program (PIP) patient attribution, Patient Profile, PRA attestation and more
  • RETACRIT supply disruption beginning in May
  • Right Price Rx, our new pharmacy savings program for commercial members

February 2022 (45 min.)

  • Medicare 5-Star measures included in the 2022 PCP Incentive Program (PIP)
  • Credentialing and enrollment in prism
  • Supporting your patients with eating disorders
  • Answers to common Cigna Alliance questions
  • Coding and documentation for diabetes

December 2021 (45 min.)

  • 2022 formulary updates, Medicare and commercial
  • 2022 prior authorization changes
  • Prism tips
  • Appeals changes
  • Coding and documentation for risk adjustment
  • Prism enhancements coming Dec. 14, 2021

October 2021 (60 min.)

  • New products and product updates for 2022, including D-SNP plans, commercial products and Medicare products
  • 2022 PCP Incentive Program (PIP) manual and updates
  • Tips to help close gaps in care this fall
  • Latest updates for prism

August 2021 (45 min.)

  • Prism, your new provider account coming this September
  • Your patients, our members, one Five-Star quality experience
  • Changes to our musculoskeletal authorization coming Jan. 1, 2022
  • THC providers can now register for Priority Health onboarding
  • GuidingCare enhancements coming Aug. 23, 2021
  • Congratulating our 2020 Quality Award winners

June 2021 (30 min.)

  • July formulary changes
  • New provider information form submission process
  • Updated secure mail options to help you get your questions answered quickly
  • New tool to help you support patients in finding community resources
  • New tools for your patients - Priority Health Connect

April 2021 (45 min.)

  • New provider portal coming soon
  • Integration with Total Health Care
  • Reminder: Deadline to join a PO for 2022 PIP participation approaching
  • Most common causes for billing denials and tips to avoid denials
  • Benefits of our new APM Roster app for PIP participating providers

February 2021 (45 min.)

  • Updates to the provider information form used to request demographic changes and more
  • Coming soon: Automation for provider information submissions
  • COVID-19 vaccine reimbursement information
  • 2021 PCP Incentive Program (PIP) updates

December 2020 (31 min.)

  • How to credential nurse practitioners and physician assistants
  • 2021 E/M billing changes
  • How to review a claim using our claims inquiry tool
  • Supporting you and your patients during COVID-19 in 2021

November 2020 (54 min.)

  • January formulary updates
  • Behavioral health platform: MyStrength
  • The importance of lead screening
  • Learn about Priority Health and Cigna Strategic Alliance and serving Cigna members in Michigan
  • Top causes for billing denials and tips to avoid

October 2020 (1hr. 8 min.)

  • New products and product changes for 2021, including, updates for our DSNP plans, commercial product updates and Medicare product updates. 
  • 2021 PIP manual and updates

September 2020 (25 min.)

  • The launch of a new authorization tool for inpatient, select procedures, behavioral health, SNFs and home care
  • How to add providers to PO/PHO contracts
  • New electronic pharmacy auth tool available: ePA Pharmacy
  • Tips and tricks for billing Medicare therapy caps

July 2020 (27 min.)

  • Medicare 5-Star challenge and how to achieve 5-star quality
  • Our new authorization tool, coming soon for inpatient, select procedures, behavioral health, SNFs and home care
  • Tips for coding and billing COVID-19 care

May 2020 (36 min.)

  • July 1 commercial formulary updates
  • PCP Incentive Program: 2019 and 2020 program updates
  • COVID-19: Supporting you and providing the latest information

March 2020 (25 min.)

  • How to use the secure email box to compose messages
  • Step-by-step guide through the new appeals process
  • Medicaid programs explained 

January 2020 (25 min.)

  • Upcoming commercial and individual benefit changes for outpatient therapy to prevent post-partum depression
  • Billing for maternity care
  • Tips for billing preventive services

December 2019 (18 min.)

  • Standard practices for billing bilateral diagnoses
  • Appropriate modifiers to use for Evaluation and Management (E&M) codes
  • Updates to our provider secure email system and our claims inquiry tool
  • Provider information form updates: What’s changed and why you should use the updated form

November 2019 (27 min.)

  • January 2020 formulary changes
  • Fee schedule updates for hand surgery
  • Coming soon: View front-end rejections on the provider portal

October 2019 (38 min.)

  • Medicare Advantage plan updates
  • Commercial plan updates
  • New: PriorityMedicare D-SNP plan
  • 2020 individual product updates

September 2019 (56 min.)

  • January 2020 formulary changes
  • New 2020 Health Risk Assessment (HRA) and Healthy Behavior requirements for Healthy Michigan Plan members
  • AHA visits and what you need to do before the year’s end
  • Tips and tricks for PIP program success 

August 2019 (34 min.)

  • How to term and add providers to your practice using the provider information form
  • Updating your information on the Council for Affordable Quality Healthcare (CAQH) provider data base
  • The most common causes for billing denials
  • Common clinical edits and how you can submit an appeal for review

July 2019 (32 min.)

  • Community Health Automated Medicaid Processing System (CHAMPS) requirements and enrollment
  • Key gaps in care
  • The Medicare 5-Star challenge and how to achieve 5-Star quality
  • Our annual provider survey
  • What you need to know about in our recent news highlights

June 2019 (28 min.)

  • How to get your questions answered quickly at Priority Health
  • The most common causes for billing denials and tips to avoid denials
  • Common code edits and how you can submit an appeal for review

May 2019 (21 min.)

  • Formulary changes coming July 1
  • Patient eligibility for our Medicaid member diaper incentive program
  • New Medicaid Tobacco Cessation outreach and Quitline initiatives

March 2019 (45 min.)

  • Coding requirements
  • Life cycle of a question at Priority Health
  • Coordination of benefits
  • Medicaid third party liability
  • Medicare STAR rating and CAHPS
  • HOS surveys

February 2019 (60 min.)

  • New member discharge policy
  • Reimbursement of payable drugs and biological agents require modifier
  • New online provider portal manual layout

December 2018 (60 min.)

  • Risk adjustment encounter data
  • PIP 2019 program
  • Thyroidectomy medical policy change
  • Orientation to the Priority Health website

November 2018 (55 min.)

  • Clinical updates
  • Colorectal cancer screening tests
  • Blood pressure best practices
  • Medicare authorizations and organization determinations
  • New product offerings

October 2018 (55 min.)

  • Formulary changes
  • Home Health upcoming changes 
  • Chiropractic changes

August 2018 (41 min.)

  • In-home health assessments
  • eviCore authorizations relaunch
  • Provider directory requirements

June 2018 (50 min.)

  • Overview of Clear Coverage®
  • eviCore update
  • Comprehensive authorizations Q&A

April 2018 (43 min.)

  • Pharmacy and formulary changes coming July 2018
  • Clear Coverage™ prior authorization tool overview

February 2018 (40 min.)

  • Risk adjustment impact for providers
  • Priority Health Academy events
  • Care management and incentive programs

January 2018 (33 min.)

  • Top 5 reasons for inquiries to Provider Services
  • Fee schedules - where to find them and how to interpret them
  • Payment take backs and reconciliations
  • New provider relations education staff
  • Call center scope change