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  • Behavioral Health Inpatient Authorization Form - Priority Health

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Behavioral Health Inpatient Authorization Form Fax to: 616.975.0249 Facility information Facility name Provider tax ID Service address Member information Last name First name Priority Health ID #.

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Tina Freese-Decker, President & CEO; Julie Fream, Chair. Spectrum Health's subsidiaries include hospitals, treatment facilities, urgent care facilities, as well as physician practices that serve the western Michigan area. Priority Health is a subsidiary health plan with one million members.

Paper claims should be mailed to: Priority Health Claims, P.O. Box 232, Grand Rapids, MI 49501.

Your Priority Health insurance can be used at any out-of-state facility in the U.S. However, if your provider does not wish to accept your insurance, and you continue to see them, they will bill you.

You have 60 days from the date you learn of a problem to file an appeal with us. Our appeal committee will look at your request and make a decision. They will send the decision to you in writing.

Cigna members living outside Michigan and getting care in Michigan. Reminder: Cigna members who are part of a Cigna Strategic Alliance are covered under the Priority Health network.

Your Priority Health insurance can be used at any outside of Michigan facility. However, your provider may not be aware of Priority Health if they are located outside of Michigan.

We're here to help you find the plan that's right for you. Call one of our Medicare experts to talk about your options at 888.230. 0372 (TTY 711), 8 a.m.-8 p.m., 7 days a week.

As a Blue Cross member, your health coverage goes with you when you travel. No matter what plan you have, you're covered for emergency care in Michigan, across the country or around the world.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232