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May 28 2026 Authorization and Claim Submission Requirements for Hospital Transfers
May 28, 2026: Attention Hospital Providers: Authorization and Claim Submission Requirements for Transfers: As a reminder, transfers from an off-campus outpatient hospital (OPH) (including Free Standing Emergency Departments) to an inpatient hospital (IPH) with the same tax ID as the originating OPH do not require prior authorization. All charges from the OPH and IPH must be submitted on one claim for the services provided.
Transfers from an OPH (including Free Standing Emergency Departments) to an IPH with a different tax ID than the originating OPH do not require prior authorization. The OPH and IPH must submit separate claims for the services provided.
All newborn transfers must be authorized by MDHHS. Authorization for emergent/urgent transfers must be requested by the next business day.
For additional information, refer to the Michigan Department of Health and Human Services [MDHHS] Medicaid Provider Manual Billing & Reimbursement for Institutional for Providers chapter.