Appeal a denied claim

Medicare reviews and Level I appeals

Medicare has a separate process. Go to the Medicare page for reviews and Level I appeals.

Commercial and Medicaid/Healthy Michigan Plan reviews

Before you can file a Level I appeal, you need to ask us to review the claim.

If you have an online account:

  1. Locate the claim online in the Claims Inquiry tool, then, from the Remittance Advice (claim detail) screen, click Email Provider Services. Within one business day, we will email you the inquiry reference number.
  2. A provider reimbursement analyst will respond to your inquiry within 5-7 business days.
  3. If your inquiry requires investigation by another department, we will notify you within the 5-7 business days.
  4. If you are not satisfied with the outcome of the informal review, you may file a Level I appeal.

If you don't have an online account:

Call the Provider Helpline, 800.942.4765, option 2, or email provider.services@priorityhealth.com.

Include your claim number and the member's contract number in all emails. For more help, see our Documentation page.