Provider Manual
- Appeal a denied claim
- Approved Drug List
- Authorizations
- Check claim status
- Check patient eligibility
- compliance policy
- Correct a claim
- Request a drug authorization
- File a claim
- Participate with Priority Health
- See medical policies
- Find provider forms
- Cigna Strategic Alliance
- Clinical resources
- Information on COVID-19 for Providers
- Medication Therapy Management (MTM) Program
- Specialty pharmacy process
- Provider fee schedules
- Formulary updates
- Provider incentives program
- Provider Roster App (PRA)
- Request an exception to the formulary
- Contact Priority Health provider services
- Set up electronic funds transfers
- Set up electronic claims / RAs
Provider news
November 20: Reminder: You must complete our 15-minute, CMS-required D-SNP Model of Care training
November 20: Reminder: Photos are required for home health wound care authorizations after 60 days
November 20: Peer-to-peer policy update cancelled
November 20: November 2024 medical policy updates
November 20: Southeast Michigan networks clarification (narrow vs. tiered networks)
November 18: New and updated billing policies now available
November 7: Scheduled maintenance dates and times for TurningPoint’s authorization portal
November 6: Get our fall Physician and practice news digest and our Medicare/Medicaid Quality newsletter
November 6: Register now to learn about our January 1 formulary changes on November 21
November 1: 2025 commercial fee schedules are available online
October 31: Commercial, individual and Medicare formulary changes coming Jan. 1, 2025
