Billing & payment news

DPP program billing reminder

Follow MDHHS billing guidelines for our Diabetes Prevention Program for Medicaid members.

June 25, 2025

Read article
May 2025 billing policy updates

We recently published or updated a series of billing policies, now available in our Provider Manual.

June 25, 2025

New and updated billing policies

Several billing policies were recently published to or updated in our Provider Manual.

June 25, 2025

Update to corrected claims goes into effect June 2

Effective June 2, 2025, all submitted claims requiring a correction – both facility and professional, regardless of any allowed / paid amount on the original claim – will require submission of a corrected claim with frequency code 7.

June 25, 2025

New and updated billing policies now available

We recently published several new and updated billing policies.

June 25, 2025

Claim dispute decisions are delivered in prism

We’re sharing a reminder that claim dispute (appeal) decisions are sent through our provider portal, prism.

June 25, 2025

We're reprocessing select doula telemedicine claims due to an error in the fee schedule

Due to a reimbursement rate error in the Michigan Department of Health and Human Services’ (MDHHS) fee schedule, we’re reprocessing doula telemedicine claims submitted under the HCPCS code S9945 between Oct. 1, 2024 and Feb. 28, 2025.

June 25, 2025

Resolving Medicaid claims rejecting incorrectly for date of death

We’re resolving an issue with some Medicaid claims rejecting incorrectly for missing or invalid date of death. We'll reprocess impacted claims; there's nothing you need to do.

June 25, 2025

New and updated billing policies are now available

The following billing policies were recently published to or updated in our Provider Manual.

June 25, 2025

RAs for January CM checks are being delivered late

Remittance advices (RAs) for our January 2025 care management (CM) payment checks are being delivered late. Checks have already been delivered.

June 25, 2025

Telemedicine billing updates effective Jan 1

At Priority Health, we align our telehealth / virtual services billing guidelines with AMA, CMS and MDHHS. AMA and CMS recently released updates effective Jan. 1, 2025.

June 25, 2025

January billing policies update

The following billing policies were recently published to or updated in our Provider Manual.

June 25, 2025