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Priority Health Provider Login: How To Access Your Account

Priority Health Managed Benefits operates as an insurance company. The Company offers Medicare and Medicaid coverage, insurance, and health care plans. Priority Health Managed Benefits serves customers in the United States. The Priority Health Provider Login portal allows providers who have online account to access their account online. If you are a new user you have to create an account to access all the tools you need to give your patients quality care–all in one place.

How To Create A Priority Health Provider Online Account

To manage patient and claims data with prism you need to create an account to access all the tools you need to give your patients quality care – all in one place. Here’s what you can do with your Priority Health Provider Online Account.

  • Claims & appeals
  • Enrollments
  • Authorizations
  • Member Inquiry

To create a Priority Health Provider Online Account go the https://www.priorityhealth.com/provider and click on “Create account

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Priority Health Provider Login Steps

Accessing the Priority Health Provider login portal is easy as far as you have already registered for Priority Health Provider online account and have your Priority Health Provider username and password. When you successfully log in to your account, you will have the access to the tools you need to manage your online account. Follow the steps below to access your account.

Priority Health Provider Login Steps

Submitting claims

Claim requirements;

All claims must be electronic or typed on paper: Priority Health will not accept hand-written claims.

Do not fax or email claims, original or corrected: Send claims only electronically or, for paper claims, through the U.S. Mail.

Use the member ID number to identify the patient: Don’t use a Social Security number. They reject electronic and paper claims submitted without a valid subscriber ID (with two-digit suffix) or Medicaid recipient ID number.

Total charges should appear only on the last page: Omit the total charges until the final page of multi-page paper claims.

Secondary claims must be billed with primary EOB: Billed charges must match the amount shown as billed on the EOB. If they don’t, your claim will be rejected as “Inappropriate EOB – does not match claim.” You will then have to rebill the claim. If a claim denies for needing the primary EOB, you must resubmit the claim with the EOB attached via electronic or paper claim submission. They do not accept EOBs via fax or email.

National Uniform Billing Committee (NUBC) standard code sets: Valid ICD-10, CPT, and HCPCS codes only Claims containing invalid codes will be denied upfront, and they will notify you within 48 hours of the denial. See the Diagnosis coding guidelines in this section.

Multiple services on the same day must bill on one claim: Effective May 1, 2018, multiple services reported by the same provider for the same day of service will be denied or adjusted to deny if services are split between multiple claims.

Use the modifier FB: When you received a drug or item at no cost and are billing that charge for informational purposes, not for reimbursement, use the modifier FB.

How to submit electronic claims;

Learn how to set up HIPAA-compliant electronic (EDI) claim files. Set up instructions

Where to mail paper claims;

Priority Health Claims
P.O. Box 232
Grand Rapids, MI 49501

Priority Health Provider Contact Information

Contact Provider Services for help:

Monday – Thursday 7:30-5 and Friday 9-5

Provider Helpline: 800.942.4765
Send them a secure email
All provider contacts

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