Skip to main content

Atypical

The Center for Medicare and Medicaid Services (CMS) defines atypical providers as providers that do not provide health care. Providers who may be enrolled in CHAMPS or Bridges and do not perform medical services (e.g. Home Help, Non-Emergency Medical Transportation (NEMT), Adult Foster Care (AFC)). Atypical providers may submit HIPAA transactions, but they do not meet the HIPAA definition of a health care provider and would not receive an NPI number. (1)

MDHHS utilizes provider email address information entered in the CHAMPS provider enrollment application to communicate with providers. Providers are responsible for maintaining accurate and valid email address information within their CHAMPS provider enrollment information. If the email address information is out of date or incorrect, enrolled providers will want to modify their enrollment information and submit it for approval.

Domain Administrator Resources


Community Transition Services (CTS)

As outlined in the policy bulletin, MSA 21-11,  CTS Agencies will be screened and enrolled in CHAMPS.

    • Facility/Agency/Organization (FAO) Enrollment Instructions: PDF
    • Rendering/Servicing Enrollment Instructions: PDF
    • Currently enrolled atypical providers needing to add the CTS specialty can submit a modification.
      • Atypical Agency Modification Instructions- PDF
      • Atypical Individual Provider Modification Instructions- PDF

Electronic Visit Verification (EVV)

As outlined in MMP 23-42 and MMP 23-76 impacted program providers of Personal Care Services (PCS) are required to obtain a National Provider Identifier (NPI) and enroll in CHAMPS with an atypical enrollment type. If you are unsure of your enrollment type or the specialty to select when enrolling review Step 2: Determine CHAMPS Enrollment Type.

  • Behavioral Health
  • Community Transition Services (CTS)
  • Home Help
  • MI Choice
  • MI Health Link

New Providers

  1. Complete a CHAMPS Provider Enrollment Atypical application. EVV Atypical Agency and FI Enrollment Instructions
  2. Once the CHAMPS Application has been submitted, complete the HHAeXchange provider onboarding form 

By completing the onboarding form this allows HHAeXchange to create the EVV Agencies provider portal and work with the Agency to begin the EVV process. The provider onboarding form must be completed regardless of if the Agency will continue to use their existing EVV vendor or the state sponsored vendor, HHAeXchange. 

To learn more about EVV visit www.Michigan.gov/EVV.


In Lieu of Services (ILOS)

As a part of MDHHS’ continuous commitment to deliver Michigan residents equitable, coordinated, and person-centered care, MDHHS will encourage Michigan’s Medicaid Health Plans (MHPs) participating in the Comprehensive Health Care Program (CHCP) to offer in lieu of services (ILOS) that address Medicaid members’ health-related nutrition needs.

ILOS are services the state deems to be medically appropriate and cost effective when provided as substitutes for other Medicaid covered services. MDHHS will designate a set of federally approved ILOS that MHPs may offer starting January 2025. 

In Lieu of Services website: https://www.michigan.gov/mdhhs/mihealthylife/michigan-in-lieu-of-services

  • CHAMPS Enrollment Instructions- PDF 

Local Education Agency (LEA)

  • CHAMPS Enrollment Instructions - PDF

Non-Emergency Medical Transportation (NEMT)

  • CHAMPS Enrollment Instructions -PDF
  • CHAMPS Revalidation Instructions -PDF

Other Atypical Provider Resources

 

Return to Provider Enrollment Home Page

 

(1) A health care provider is defined under HIPAA in federal regulations at 45 CFR 160.103