Priority Health is Improving Their Peer-to-peer Process with a Single Phone Line
Effective July 1, you will have one phone number to call if you want to schedule a peer-to-peer conversation with a medical director for inpatient and outpatient services. The phone number is 616.464.8432. Additionally, Priority Health has expanded their hours of operations. You can contact them Monday—Friday, 8:30 a.m. - 4 p.m. There’s no change to the process for behavioral health services. Providers can continue to call 616.464.8500.
Historically, they had multiple phone lines depending on the type of service the provider was calling about. the single, centralized line will provide an easy scheduling solution.
The purpose of peer-to-peer discussion is to exchange information regarding the medical necessity of a denied prior authorization request. The call does not take the place of documentation required to support authorization.
You must schedule a peer-to-peer review within certain time frames, which vary depending on the authorization type.