Provider onboarding center

Whether you've just joined our network or you've been with us for a long time and are just looking for refreshers, we're thrilled you're part of the Priority Health family. Please bookmark this page and share it throughout your organization (especially with any new staff), so you and your team can refer to it frequently as you work with us.

If it's your first time here, please check out the welcome video from one of our team leaders below.


Resources

Expand the drawers below to find the resources you need to start working with Priority Health.

Joining the Priority Health network

Training topics

Here are a few basic how-to guides for some of the things you'll need to do most frequently.

Please also review our VOA Modules page for short videos on a variety of other topics.

Staying in the loop

There are several ways of accessing the latest updates from Priority Health. Be sure to use one or more of the following resources to stay in the loop on updates that may directly affect you:

Out-of-state provider information

If you are an out-of-state provider (outside of Michigan), start here for helpful information:

Go-to tools

Here are just a few of the tools you'll find most useful as a member of the Priority Health network. It may be helpful to bookmark them in your browser.

Getting your questions answered

If you have questions and/or need assistance from the Priority Health team, please consult this document to determine how to approach the situation. Information is included on:

  • self-service tools
  • inquiries
  • Priority Health's Provider Helpline

Priority Health products

We have a variety of products in our various lines of business: individual, commercial, Medicare and Medicaid. Browse the following links for more information:

Incentive program information

Our PCP Incentive Program (PIP) is a cornerstone of our relationship with providers. While most PIP information (including the manual) can be found on prism, you can read general information on the program in a recent news update here.

FAQs

Yes! Priority Health does indeed have a portal specific to providers and provider organizations, groups and hospitals.  This portal is called prism and it is your access to verifying member eligibility and benefits, submitting authorization requests, checking claim statuses, filing appeals and submitting other questions.  

Priority Health has a page in our provider manual which was been created to show you how to register, navigate and manage your prism account. This page contains a quick start guide as well as FAQs and video tutorials to walk you through how to best leverage the tools available.

There are resources in our provider manual dedicated to adding or removing providers or changing practice information with Priority Health.  These informational resources will advise you on how you can submit these change requests, as well as track the status of your request through prism. 

Priority Health’s resources can advise you on whether an authorization is required for a certain service as well as how to submit your authorization request and track the status.  See our provider manual for more information. Note that certain actions will prompt you to log into your prism account. 

Our billing & payments page on our provider manual covers a wide range of topics from how to submit claims to Priority Health, what information needs to be included in a claim submission, corrected claim procedures and much more.

Prism is your go-to place to verify the status of your unpaid claims, or to confirm the payment details of claims which have completed processing.  By logging into prism and selecting “Claims” from the navigation bar, you can search for member claims and verify these details. Have questions about your claim or need to file and appeal? Click on “Contact Us” at that top of the claim to submit a question or request to us. Your question will be reviewed and sent back to you through prism. You can also utilize prism to view your front-end-rejected claims. If you prefer to receive electronic service receipts for your rejected claims you can register for our electronic data interchange (EDI) service here.

Prism contains an EFT request form in the "Resources" selection of the prism navigation bar. Just click on Resources and select “Set up EFT." If you would like to review Priority Health’s informational details about EFT, you can click on “Set up electronic funds transfer” in the billing and payments section of our Provider Manual. For more information, visit our provider manual.

Yes. Priority Health has a data exchange called Filemart where you can access various data files. Visit our provider manual to review setup for Filemart and for information pertaining to setting up and accessing EDI files.

Any questions related to contracting (including rates), provider enrollments/changes or incentive payments should go through your organization. Anything related to service or payment at the level of your specific building/entity within the organization should be directed to Priority Health. Consult our "Get your questions answered" document for more details.

The busiest times for the Provider Helpline tend to be between 10:00–noon and between 2:00–4:00. So call early (we start taking calls at 7:30 Monday–Thursday and 9:00 on Friday) or between noon–2:00 for the shortest wait times. However, you can also avoid the wait entirely by checking the "Get your questions answered" document and finding what you need without picking up the phone.

We have numerous member programs to help supplement the care you provide our members. See a full list of the member programs we offer here.

Your network effective date will come through a comment in prism. (An email will let you know a new comment has been posted.) You can start seeing Priority Health members on this date.

Our site lists all member rights and responsibilities.

Priority Health members have the right to file requests, complaints, grievances and appeals. Learn more here.