10/06/2021

Priority Health Update

Priority Health Managed Care Committee Member

Flora Varga, Cancer & Hematology Centers of West Michigan

Attention MSHO Members:  (Note from Flora Varga)

Anyone receiving denials on the following lab panel codes 80053, 85025 & 84443? 

These charges were billed without code 80050. These lab panel codes have been getting paid until recently.

Priority Health Medicare will have an answer as soon as possible.

Priority Health provider onboarding and training for Total Health Care provider is available on demand

Were you unable to attend our live provider onboarding and training sessions for Total Health Care providers? You can now view the recorded Priority Health provider onboarding and training session.

Assist members newly transferred from THC products with updating their medications

What you need to know:
Review your newly transferred members' medication list against our Approved Drug lists. Doing so will ensure their members continue to receive high quality care at the lowest cost possible. READ MORE

New Preferred Products for Medicare Part B Drugs Start Oct. 14

Starting Oct. 14, we’ll have preferred products for two classes of Medicare Part B medications: Hyaluronic Acid (HA) Derivatives and Erythropoietin Stimulating Agents (ESA).

We will require patients who have a new prescription to use the preferred products for the Medicare Part B drugs below. Members who are already using the non-preferred products may be changed to preferred products, but this will not be required.  (Includes Erythropoietin stimulating agents.)   

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