10/20/2021

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.

You should no longer accept THC Medicaid member IDs

We still have commercial group and individual members with THC coverage. Make sure to check each patient’s coverage at every visit. The commercial THC coverage is valid through the plan ending date or until Jan. 1, 2022.

What’s changing
Commercial THC members have the opportunity transfer their coverage to Priority Health as their current coverage expires. THC commercial plans will be completely phased out by Jan. 1, 2022.

As of Oct. 1, 2021, THC Medicaid members were transferred to Priority Health. You should no longer accept THC Medicaid member IDs.