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. 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 at the Provider Enrollment Website.
For any Billing Agent related questions, please contact AutomatedBilling@michigan.gov.
|All Michigan Medicaid Billing Agents will need to complete the B2B Testing process to ensure proper submission of HIPAA compliant transactions.|
|5010 270 ACA Test Instructions|
|5010 276 ACA Test Instructions|
|Medicaid Provider Policy and Forms Information
Medicaid Provider Manual, draft and final policy bulletin, etc.
|HELPFUL 5010 LINKS|
| Magellan Medicaid Administration