Complete Story
07/15/2024
Priority Health Update
Priority Health Managed Care Committee Member
Flora Werle - Cancer & Hematology Centers of West Michigan
Click here to visit the Priority Health Provider News Page for additional updates.
New Features Now Available for Teladoc Health Mental Health Wellness Tool
We recently added new features to the Teladoc Health Mental Health wellness tool to streamline the account creation process and provide members with additional support based their intake questionnaire and goals. Formerly called myStrength, Teladoc Health Mental Health is a free, self-help mental wellness program for all Priority Health members ages 13+. Available to use as an app or through the website, the program features more than 1,400 activities on a variety of mental wellness topics including depression, anxiety, stress, chronic pain, sleep problems, substance use and more.
New program features
- Engagement guide: The guide offers text-based support to encourage positive behavioral change while the member works through the program. Asynchronous messaging within the tool is available to all users. Clinical treatment isn’t provided.
- Crisis outreach: This includes phone outreach by a trained crisis manager but is only prompted when a member answers “nearly every day” on the suicide question in the depression screening. Only available for members 18 and older.
- Live virtual coaching: This includes live sessions with a certified coach for members 18 and older with mild or subclinical acuity.
What do members need to know when creating an account?
Members no longer need to enter an access code when creating an account; they only need to enter basic information (name, birthdate, etc.) and confirm their health plan details. If a member’s health plan isn’t listed, they can contact Teladoc Health support at 800.853.2362 or and ask for assistance to sign up for the mental health program.
What do providers need to know?
Encourage your patients to sign up for a free account today. Help and support Members can reach out to Teladoc Health’s member support team for assistance by calling 800.835.2362 or emailing membersupport@teladochealth.com.
Annual Reminder: You Must Refer Members to In-Network Providers, Including Labs
To help ensure our members get the highest quality, most affordable health care through our network partners, you’re required to use labs that participate in our network. Participating providers have a contractual obligation to use in-network providers when referring our members for services, regardless of your own contracts for referrals with non-participating labs.
Out-of-network labs are not covered for members with HMO plans without an approved authorization, even if the lab is performed on the same day as an office visit with a participating provider.
If an HMO member chooses an out-of-network lab despite the provider’s guidance, the member is responsible for the payment. Under Michigan’s surprise billing legislation, for this to occur, the member must sign documentation from the provider that includes:
- A statement that their insurer may not cover all services
- A "good-faith" estimate for services to be provided
- A statement that the member may request care from an in-network provider and can contact their health plan to discuss
What should providers and facilities do?
Refer your patients to in-network providers and facilities. Use our Find a Doctor tool to find labs that are in-network for your patient’s unique plan. If an out-of-network lab is the only option, follow the steps to request an authorization.
If a Priority Health member chooses to use an out-of-network provider or facility without prior approval, inform the member in writing that they will be responsible for any costs, and ensure you have a documented signature from them affirming their choice.
If an out-of-network lab is necessary for a particular service, a prior-authorization is required. Learn more about reference lab billing.
We’re always here to help
If you can’t find an in-network lab using the Find a Doctor tool, contact the Provider Helpline at 800.942.4765.
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