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09/15/2025

****WIP**** Priority Health Update

Priority Health Managed Care Committee Member

Flora Varga

Flora Werle - The Cancer & Hematology Centers



Click here to visit the Priority Health Provider News Page for additional updates. 



Register Now for Our September 25 Billing & Coding Webinar
Join us for our last billing & coding webinar of the year on Thursday, September 25 at noon to learn about:

  • Remittance advices – access for you and third-party billing companies
  • Tips on coding quality and coding for gap closure
  • Claim disputes: what we’re looking for
  • Billing policies overview 

How to register
You can join us by registering online.

Can’t join us?
All webinars are recorded and posted to our provider webinars page within a week of the event, so you can watch at your convenience.


Improved PIP Reporting, New Report Vendor Coming in 2026
We’ll soon be working with a new vendor – CitiusTech – to deliver PCP Incentive Program (PIP) reports to our Accountable Care Networks (ACNs), starting with the 2026 performance year.

Why are we making this change?
With this change, we seek to improve your experience accessing and ingesting your PIP reports. You can expect clearer care gap reporting, supplemental data feed improvements, and consistent delivery of PIP reports via the provider portal – no more email attachments landing in your inbox throughout the month.

Note: This change only impacts PIP reports. Other reports (i.e., Disease Burden Management program (DBM), Alternative Payment Models (APM), Quality) will continue to be delivered as they are currently.

Help us test the new reports
ACNs are invited to test the new PIP reports later this year. If you're interested, let your Provider Network Management consultant know.

More to come
When we’re closer to launch, we’ll offer provider training webinars, covering how to navigate the tool and access/download reports. We’ll also offer written training materials to support a successful transition.


 

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