Coverage Change Affecting Employees With Priority Health Care

GRCC was just notified of a change that may impact you and your family. Priority Health advised us that emergency room doctors at six hospitals have refused to join their network. This results in fees that are significantly above market, driving up overall costs. As a result, Priority is going to begin sending payment directly to patients who receive ER services at:

  • Holland Hospital (Holland)
  • Metro Health Hospital (Grand Rapids)
  • MHP Mercy Campus (Muskegon)
  • MHP Hackley Campus (Muskegon)
  • North Ottawa Community Hospital (Grand Haven)
  • St. Mary’s Health Care (Grand Rapids)

This new process began on April 1:

  1. Claim is received by Priority Health
  2. The check for the full amount (less coinsurance/deductibles) is mailed directly to the employee. If the patient is a dependent of the employee, the check will be made out to both the employee and the dependent.
  3. Physician group bills you directly
  4. The employee pays the physician group

Priority Health continues to negotiate with these ER provider groups to reach a fair agreement, and will keep us updated on any developments. If you have any questions please contact customer service at 800-446-5674.

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