Electronic Billing

  (Updated February 19, 2008) January 10, 2008 - As of January 1, 2008, MDCH is no longer accepting new Billing Agent ID Request Forms.  Any new billing agents that wish to enroll will need to wait until March 2008, when the new CHAMPS Provider Enrollment system will be live.

  December 4, 2007 - MDCH is encouraging all Billing Agents to begin testing the 10 digit beneficiary ID change. Throughout the month of December, every Tuesdays and Thursdays all B2B test files will report back the 10 digit ID on all outbound transactions.

  November 6, 2007 - MDCH has identified issues with the NPI reporting back incorrectly on the 835 (Electronic Remittance Advice) for pay cycles 41-45. Beginning November 14th, pay cycle 46, the 835 should be reporting back the correct NPI number in the TS3 segment of the 835. For more information on what is expected to be returned in the 835 file, please view the 835/277U Companion Guide located on our website at www.michigan.gov/medicaidproviders>>Electronic Billing.  If you have any questions on this issue please contact AutomatedBilling@michigan.gov. 

  October 23, 2007 -  MDCH has identified NPI issues for Pay Cycle 40, 41and 42.  MDCH has resolved all internal issues and providers may resubmit all claims that rejected in error for NPI issues.  Providers may be experiencing edits 634, 635, 636 and 639 on their RAs.  These are valid edits that will set if an NPI is missing or invalid, or if an invalid zip code is reported.  If you have a valid NPI and you are still receiving the edits above, make sure that your NPI has been reported to MDCH through our Single Sign-On (SSO) application.  If you have not reported your NPI to MDCH, please find instructions at the NPI website at www.michigan.gov/mdch>> Providers >> NPI.  

  October 2, 2007  -  Effective pay cycle 40, October 3, 2007, provider warrants will be issued on Thursdays. This is a change from the current practice of issuing warrants on Wednesday. The change will not affect provider payments issued via Electronic Funds Transfer (EFT), which will continue to be processed on Thursdays.  EFT is the method of direct deposit of State of Michigan payments into a provider's bank account. This replaces a paper warrant. Providers interested in initiating an EFT may do so through to the Department of Management and Budget website at www.cpexpress.state.mi.us.

  August 24, 2007   -  MDCH is offering Business to Business (B2B) Testing for claims with NPI only to all Trading Partners. MDCH encourages the submission of test files with NPI only to guarantee claims will adjudicate correctly and that all Billing Agents will be able to receive and download the 835 (Electronic RA) file properly.  MDCH will be mandating the use of NPI only on October 1, 2007. 

   UPDATED BILLING AGENT INFORMATION - Form to be filled out by ALL Billing Agents to help MDCH prepare for the CHAMPS Provider Enrollment Subsystem. February 2008 all Billing Agents must revalidate their information in the new CHAMPS Provider Enrollment Subsystem.  Any questions, please contact AutomatedBilling@michigan.gov. 

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Submitting Claims Electronically

• Steps for Submitting Claims Electronically
• 837 B2B Testing Instructions

Electronic Submission Guides

• Electronic Submission Manual - March 1, 2006
• DEG Web User Guide
• Electronic Submissions Manual  - October 4, 2002
• Electronic Submissions Manual - December 20, 2001

Additional 835 Information

• 835/277U Change Request Form
• MDCH Explanation Code Crosswalk :  Adobe or Excel
• Reason and Remark Codes

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Companion Guides

Implementation Guides can be purchased at http://www.wpc-edi.com/products/publications. 

• 837 v 4010A1 Dental Companion Guide
• 837 v 4010A1 Institutional Companion Guide
• 837 v 4010A1 Professional Companion Guide 
• 835 v 4010A1 Companion Guide
• 277U v 4010A1 Companion Guide
• 278 v 4010A1Companion Guide
• 276/277 v 4010A1 Companion Guide
• 270/271 v 4010A1 Companion Guide

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Approved Billing Agents

 When looking for an electronic submitter, please be sure you are getting exactly what you want.  Some questions to ask submitters:

1. Does the billing agent submit claims directly to Michigan Medicaid or are they use a clearinghouse?
2. Can the billing agent submit secondary and tertiary claims to Michigan Medicaid?
3. Can the billing agent submit crossover claims from Medicare, or will the billing agent have the capabilities to submit the crossover claims when available?
4. Is the billing agent currently on the Approved Billing Agent list below?  If not, are they currently testing with Michigan Medicaid to do so?

• 837 v 4010A1 Dental
  837 v 4010A1 Institutional
• 837 v 4010A1 Professional

The "New Provider" column in all of the lists above, represents if the billing agent has notified Medicaid that they are now accepting new providers. 
Providers or Billing Agents with any electronic billing questions may contact EDI services at AutomatedBilling@michigan.gov

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