Priority Health provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.priorityhealth.com/provider |
|---|---|
| Payer contact reference | 1-800-942-4765Provider Helpline; option 1 claims |
| Claims payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| ERA payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| Timely filing | Complete billing within 12 months of service; correction exceptions apply |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- Provider Helpline; option 1 claims
- Priority Health’s current provider manual requires billing and discrepancy resolution within 12 months of service. Medicare and Medicaid credited-charge corrections have an exception and must follow corrected or void-claim instructions. Confirm the product, governing agreement and correction rules; do not substitute a fixed day count.
- This registry has not established a payer-specific appeal ladder for Priority Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Priority Health at a glance
| Legal name | Priority Health |
|---|---|
| Also known as | Priority Health Plan |
| Category | Commercial |
| Parent organization | Corewell Health |
| Claims payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | Michigan |
| Members covered | ~1.3 million members |
| Provider resource entry point | https://www.priorityhealth.com/provider |
| Provider phone | 1-800-942-4765Provider Helpline; option 1 claims |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Priority Health
Priority Health’s current provider manual requires billing and discrepancy resolution within 12 months of service. Medicare and Medicaid credited-charge corrections have an exception and must follow corrected or void-claim instructions. Confirm the product, governing agreement and correction rules; do not substitute a fixed day count.
| Submission type | Window |
|---|---|
| Initial claim reference | Complete billing within 12 months of service; correction exceptions apply |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Priority Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Priority Health provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Priority Health
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Priority Health electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Priority Health. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Priority Health
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Priority Health volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | 38217 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 38217 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone
Source comparison: 2026-09-26
The current canonical contact page lists Provider Helpline 800-942-4765; menu option 1 is claims and option 2 eligibility/benefits. Stored 800-942-0954 is not this provider line.
Primary source for provider_phonetimely_filing_days
Source comparison: 2026-09-26
Current manual requires billing and discrepancy resolution within 12 months of service, not the stored 180-day default. Medicare/Medicaid credited-charge corrections have an exception and must be billed as corrected or void claims.
Primary source for timely_filing_days
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.claims: No universal medical claims identifier established; preserve clearinghouse and product verification.; payer_ids.eligibility / payer_ids.era / era_payer_id: No transaction-specific universal eligibility/ERA identifier established; do not copy a claims ID.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
State coverage
Priority Health operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Priority Health
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Priority Health; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Priority Health; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Priority Health before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Priority Health
Where is the Priority Health provider portal?
Use https://www.priorityhealth.com/provider as a starting point for Priority Health provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Priority Health?
Priority Health’s current provider manual requires billing and discrepancy resolution within 12 months of service. Medicare and Medicaid credited-charge corrections have an exception and must follow corrected or void-claim instructions. Confirm the product, governing agreement and correction rules; do not substitute a fixed day count.
What is the Priority Health payer ID?
Claims: 38217 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): 38217 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 38217 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does Priority Health accept electronic claims?
Verify Priority Health electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Priority Health denial?
This registry has not established a payer-specific appeal ladder for Priority Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Priority Health prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Priority Health provider phone number?
This registry lists 1-800-942-4765 as a contact reference for Priority Health. Provider Helpline; option 1 claims
Automate workflows around Priority Health requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Priority Health's current published documents before submission. CPT® is a registered trademark of the American Medical Association.