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07/20/2022

Priority Health Update

Priority Health Managed Care Committee Member

Flora Varga

Flora Varga, Cancer & Hematology Centers of West Michigan



Legacy THC providers must wrap up claims, appeals by Dec. 31, 2022

As our merger with Total Health Care (THC) is complete, THC will officially cease operations on Dec. 31, 2022. Legacy THC providers must wrap up any outstanding claims and appeals as outlined below.

What does this mean?  READ ARTICLE



New clinical edits for facility claims going into effect on Sept. 15, 2022

We value the care you provide our members and strive to reimburse you accurately and fairly for that care. Thoughtful implementation of clinical edits supports this goal, while allowing us to process your claims more efficiently.

On Sept. 15, 2022, we’ll implement the new clinical edits outlined below. We adopted each from Center for Medicare and Medicaid Services (CMS) guidelines. These edits will impact facility claims only, for all products. READ ABOUT EDITS



Visit the Priority Health Provider News Page for Additional Updates:  CLICK HERE



 

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