When submitting electronic claims it is possible for Clearinghouses, Software Vendors, Billing Agents, and Service Bureaus to all handle electronic claims.  They are all classified differently and some can be considered multiple depending on the type of business that they complete. Only a Billing Agent will be able to enroll within the Michigan Medicaid system.

BILLING AGENT INFORMATION

A Billing Agent is the business authorized by MDCH to submit Medicaid HIPAA compliant transactions.  

Before any organization can receive a Billing Agent ID there is information that must be completed.  To receive a Billing Agent ID, the Billing Agent MUST be able to complete HIPAA compliant transactions, review the Electronic Submissions Manual, Companion Documents and Implementation Guides, and submit the Billing Agent Enrollment Application for approval. Michigan Medicaid will not allow testing for non-HIPAA compliant transactions.  Once the enrollment application has been approved by MDCH the Billing agent will receive a Billing Agent ID and Data Exchange Gateway (DEG) user ID and password. All providers must associate to the corresponding Billing Agent within the CHAMPS system. This association provides the Billing Agent with the authorization to submit claims on behalf of the Provider. If the Provider has not associated the Billing Agent in CHAMPS all testing and production claims will deny. All Billing agents must also complete the B2B Testing requirements prior to submitting production claims (The B2B process is currently being revised as MDCH implements the new CHAMPS system) .

Below is a summary document on the MDCH requirements for submitting claims electronically:
Submitting Claims Electronically

HOW TO ENROLL AS A BILLING AGENT

If you would like to become a Michigan Medicaid Billing Agent, you MUST complete the Billing Agent enrollment application within the CHAMPS system. The CHAMPS Web Application resides within the Michigan Department of Community Health (MDCH) Single Sign-On (SSO) website. In order to access CHAMPS, you will need to have a valid SSO account. To register for a SSO user ID and Password please visit https://sso.state.mi.us.  

For step-by-step instructions on how to complete the Enrollment process in CHAMPS, please view the documents or webinar listed below:

Billing Agent User Guide
Billing Agent New Enrollment Quick Reference Guide
New Enrollment Webinar

MICHIGAN MEDICAID APPROVED BILLING AGENTS

All providers listed below have been through the B2B Testing process and are approved Billing Agents by Michigan Medicaid.  The testing that a Billing Agent must go through makes sure they can submit basic criteria requirements which includes the ability to submit secondary and tertiary claims. 

·           837 v 4010A1 Dental Approved Billing Agents  

·           837 v 4010A1 Institutional Approved Billing Agents

·           837 v 4010A1 Professional Approved Billing Agents  

For any Billing Agent related questions, please contact AutomatedBilling@michigan.gov .