Claim deadlines and timely filing
You must complete billing, including resolving all claim discrepancies, within 12 months of the date of service. After that date, we will deny corrected or augmented information as provider responsibility.
Review the status of your claim
- Review your claim in the Claims Inquiry tool.
- If it's not listed under your claims online, review your service receipt for rejected claims and reasons for rejection.
- If the claim is not listed in either place, you may re-submit it within 45 days of your original submission.
Medicare or Medicaid/Healthy Michigan Plan claim deadlines
We accept claims submitted for payment more than 12 months from the date of service if the claim includes charges credited (charges removed from the originally processed claim).
Claims must be billed as a corrected or void claim to bypass the filing limit without an automatic rejection. See claim corrections information for the UB-04 and CMS-1500.
Deadlines for correcting claims
See Correcting claims in this Provider Manual.
Submitting electronic claims
How to set up HIPAA-compliant electronic (EDI) claim files.
Mailing paper claims
Priority Health Claims
P.O. Box 232
Grand Rapids, MI 49501
- Status claims
- Claims Inquiry tool guide
- Edits Checker tool guide
- Claim deadlines
- Set up electronic payments
- BH provider billing
- Facility billing
- Advanced practice professional billing
- Professional billing
More billing topics:
- ACA non-payment grace period
- Ambulatory surgery center billing
- Balance billing
- Clinical edits
- Check reissue procedure
- COB: Coordination of benefits
- Correcting claims
- Correcting overpayments & underpayments
- Diagnosis coding
- Drug Coverage
- Dual-eligible members
- Front-end rejections
- Gender-specific services
- Medicaid billing
- Modifiers
- NDC numbers on drug claims
- Office-based procedures billing
- Risk adjustment
- Unlisted codes, drugs & supplies