Priority Health Has a New Updated Discharge Policy and New Online Discharge Process
On November 1, 2018, Priority Health announced their updated discharge policy would go into effect on January 1, 2019. The updated policy is now available online.
The policy clarifies criteria for patient discharges, which are limited to instance of abuse:
- Unpaid copayment or deductibles
- Repeated no-shows
- Threatening behavior
- Failed drug screen
- Fraudulent behavior
In addition, for the PIP and CPC+ programs, non-adherent exclusions have been expanded to include failure to establish care and non-compliance.
Priority Health also shared they were working hard to move discharge requests online. They’re happy to announce that you are now able to enter discharges on Patient Profile to help reduce your administrative burden. To learn how to use Patient Profile for discharges visit Discharging a patient from care.
This discharge process applies to members of all Priority Health products. As a reminder, PPO members are attributed monthly based on their claims unless they have selected a PCP.
***Priority Health is no longer able to accept fax, email or paper forms for patient discharges.***