Priority Health Has Changes Coming to the Appeals Process
Your needs as a network partner are always top of mind for Priority Health. They’re constantly seeking ways to innovate and evolve to ease your burden. That’s why they’re excited to share upcoming changes that will simplify post-claim appeals.
Starting November 1, 2021, you’ll follow this process:
- Submit an Informal Review request through our Claims Inquiry tool. If you’re unsatisfied with the outcome of this review, you can then:
- File a Level 1 appeal with all supporting documentation, within 180 days of the first remittance advice, using either our Claims Inquiry tool or Secure Email.
This new process removes the Level II appeal and concentrates the timeframe for Level 1 appeals, to make sure appeals are processed and finalized as quickly and accurately as possible for you and your patients. With this shift, it’s important to note that duplicate Level 1 appeals won’t be accepted.