A Rendering/Servicing provider is one who provides services through a Group, Facility, Agency, Organization or an Individual/Sole Proprietor. A Rendering/Servicing provider does not bill directly to Michigan Medicaid. The Billing Provider that is associated to this applicant type, submits claims and receives payments for the Rendering/Servicing provider. This Billing Provider must be approved in CHAMPS prior to the submission of a new enrollment application for a Rendering/Servicing provider.
- Rendering Enrollment Checklist - PDF (The intent of this resource is to provide a document that can be prefilled with the required information for completing a provider enrollment application to allow for ease of completion.)
- CHAMPS Enrollment Application: Rendering/Servicing User Guide
- Primary Specialty - PDF
- Quick Reference Guide - PDF
- Track Application- PDF, Recording
Domain Administrator Resources