From Priority Health, the latest updates to our offices:
TRAINING OPPORTUNITIES
Register now to learn about our 2025 product updates on Oct. 17
Join us for a webinar to learn more about Priority Health’s 2025 product updates across lines of business and the ways these product changes impact you, the provider.
This session will cover:
- Commercial group product updates, including the HMA third-party administrator (TPA) product, a new narrow network product called PriorityIntegra and a musculoskeletal centers of excellence rider
- Individual product updates and reminders about MyPriority narrow network plans
- Medicare product and benefit updates
- Medicaid rebid impacts
Can’t join us?
All webinars are recorded and posted to our website within a week of the event, so you can watch at your convenience.
CLINICAL RESOURCES
We’ve added exclusion criteria to our SUPD provider tipsheet
We’ve updated our HEDIS Statin Use In Persons with Diabetes (SUPD) provider tipsheet to include exclusion criteria and associated billing codes for the SUPD measure. You can download the provider tipsheet or find it on our Quality Improvement page (login required) in prism.
Have you visited our Quality Improvement page?
You’ll find tips for success in HOS, HEDIS and CAHPS along with downloadable educational resources.
REQUIREMENTS AND RESPONSIBILITIES
Reminder: groups must now have a pSA to affiliate prism users
As previously communicated, prism users will only be able to add new provider affiliations to groups or facilities that have a prism Security Administrator (pSA). If the group doesn’t have a pSA, users requesting a new affiliation won’t be able to access the group’s data until the group assigns a pSA. This means users won’t be able to use prism for the group to submit authorizations, see claims or appeals, etc.
What do you need to do?
If you don’t have a pSA assigned for your group, you’ll need to assign one immediately to ensure all prism users who need to affiliate to your provider facility can get access to authorizations, claims and more. Please allow two weeks for our team to review the application and contact your office.
To become your group's pSA, submit a request through prism under General Requests, then prism Security Admin (pSA) Assignment. Whoever becomes your group’s pSA should be a prism user who’s already affiliated to your group and in an administrator role at your organization.
If your group already has a pSA assigned, no action is needed.
Why are we making this change?
This change is the first phase of our pSA mandate, an important step to increase data security for our providers and members. By ensuring that all prism users are actively approved before accessing your group’s data, rather than automatically approved, we’re significantly decreasing the risk of data breaches.
What’s next?
Later in 2024, the second phase of our pSA mandate will take effect. Existing prism users affiliated with your group will lose access to your group in their prism account if you don’t have a pSA assigned. If you have a pSA assigned, you’re all set.
Questions?
Visit the prism resources page in our provider manual, where there are guides, FAQs and help line numbers listed.
PRIORITY HEALTH
Helping alleviate fall risks for your Medicare patients
It’s Falls Prevention Awareness Week, and we’re highlighting our programs and benefits that can help decrease fall risks for your Medicare patients. Check out the Priority Health Falls Prevention page and download our falls prevention provider tipsheet.
Get our 2024 member outreach calendar
Get our 2024 member outreach calendar; a new resource that helps keep you up-to-date on our 2024 member outreach initiatives. The outreach calendar includes:
- A snapshot of our annual member outreach initiatives across all plans
- An outline of each campaign, including plan type, timing, impact and provider incentive opportunity
- Member incentive information
You can find the 2024 member outreach calendar on the Quality Improvement page in prism (behind login).
National Prescription Drug Take Back Day coming Oct. 26
We’re pleased to participate again in National Prescription Drug Take Back Day on Saturday, Oct. 26, 2024. We invite your patients and all community members to drop off their expired, unwanted or unneeded prescription medications for safe disposal from 10 a.m. – 2 p.m. at one of the locations listed below.
In West Michigan, we’re partnering with Corewell Health, Kent County Health Department, Pine Rest and Families Against Narcotics to host collections sites at:
Kent County Health Department
700 Fuller Ave. NE, Grand Rapids
Corewell Health Grand Rapids Hospitals Care Center - Cutlerville
(North side of the building)
80 68th St., Grand Rapids
Priority Health
3111 Leonard St. NE, Grand Rapids
During last October’s Take Back event, we collected 323 pounds of medication and distributed 77 NARCAN® kits at our Grand Rapids sites.
We’ll distribute NARCAN® kits this year as well.
If you’re not in West Michigan, look for a collection site near you.
Please join us in educating community members about the importance of properly disposing of unused or expired medications to help reduce substance use.
Have patients with substance use conditions?
Contact our care coordination team
Our behavioral health department has clinical staff who specialize in helping members manage complex and chronic mental health and substance use conditions. Our care coordination team is available to support you as you help your patients get the outpatient care they need or successfully transition from a hospital setting back into the community.
Encourage your patients to try Teladoc Health Mental Health
Teladoc Health Mental Health is a digital tool that offers over 1,400 self-directed activities on a variety of mental wellness topics including alcohol and drug recovery as well as opioid recovery. These tools are available to our members 24/7 and complement the care you provide them to create real, lasting change. Encourage your patients to sign up for a free account today.