Contact provider services

Provider Helpline

8009424765

Mon.-Thurs. 7:30-5; Fri. 9-5

Press:

1 – Claims, benefits, eligibility
2 – Pharmacy
3 – Authorizations, health management status
4 – Behavioral Health
5 – Password help
6 – Connect to 5-digit staff extension
7 – Contracting, credentialing

Get your questions answered

Use our Get your questions answered help guide to direct all of your claims, credentialing, enrollment and general portal questions. Using the proper channels will help you to hear from us quickly. 

Get your questions answered guide

Appeals contacts

Log into your prism account and click Appeals. There you'll be able to initiate authorization and claim appeals by sending a secure message to our team, as well as see the status of your requests.

For instructions and forms, check our Appeals page.

Authorizations, authorization status contacts 

800.942.4765, option 3

Mon.-Thurs. 7:30-5; Fri. 9-5

Urgent after-hours authorizations only

Call 800.269.1260. Leave a phone number and message. A nurse care manager will return your call within 30 minutes.

Auth status

Log into your prism account and click Authorizations, then Auth Inquiry to see the status of your authorizations.

Fax 616.942.0024

Priority Health Authorizations
MS 1255
1231 East Beltline NE
Grand Rapids, MI 49525

Prior auth reference list

Behavioral health contacts 

Emergency treatment for behavioral health conditions doesn't require prior authorization.

Non-emergency inpatient authorization requests, fax to: 616.975.0249

A clinician will contact you during regular business hours.

800.673.8043

Mon.-Fri. 8-5

Auth forms

Claims contacts

For fastest service: Request a Priority Health provider account, then log in to use our Claims Inquiry tool.

Submitting claims

Status a claim

Log into your prism account and select the appropriate option under the Claims menu to see the status of your claims.

No DCN number?

Log into your prism account and within the Claims section, review front-end rejected claims. If you don't see your claim, go to General Requests, click New Request and choose the option "Claim not found > 60 days."

Contracting

800.942.4765

Mon.-Thurs. 7:30-5; Fri. 9-5

provider.contracting@priorityhealth.com (general)

phancillarycontracting@priorityhealth.com (ancillary and behavioral health)

Priority Health Contracting
MS 2320
1231 East Beltline NE
Grand Rapids, MI 49525

Credentialing, enrollment

Log into your prism account and click Enrollments & Requests. There you can submit new individual and organization enrollment requests and change requests. You can also see the status of your requests by clicking the Inquiry ID.

Priority Health Provider Enrollment & Life Cycle
MS 2320
1231 East Beltline NE
Grand Rapids, MI 49525

Credentialing

Drug authorizations, formulary exceptions

800.466.6642

Mon.-Thurs. 7:30-7; Fri. 8-7; Sat. 8:30-Noon

Pharmacy Help Desk

Fax 616.942.8206