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Rendering/Servicing
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.)
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 If the email address information is out of date or incorrect, enrolled providers will want to modify their enrollment information and submit it for approval.
Community Health Workers (CHW)
A CHW/community health representative (CHR) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. CHW providers seeking reimbursement for their professional services to Medicaid beneficiaries are required to be actively enrolled ion CHAMPS.
Before starting the CHAMPS Provider Enrollment application, the CHW provider should have:
- Obtain a (Type 1) National Provider Identifier (NPI) as a Rendering/Servicing-Only and
- Complete the MI Medicaid CHW Registry online application process
- A CHW must be verified and added to the MI Medicaid CHW Registry. MiCHWA, in partnership with the Michigan Primary Care Association, is the designated vendor to provide verification and credentialing services.
Resources
- CHW Beginner Guide
- MI Medicaid CHW Registry
- February 14, 2024: CHW: CHAMPS Provider Enrollment Introduction: PDF, Recording
- February 7, 2024: CHW: MI Medicaid Registry Process- PDF, Recording
Domain Administrator Resources
- Domain Administrator Functions- PDF
- Electronic Signature Agreement Cover Sheet MDHHS-5405
- Electronic Signature Agreement DCH-1401
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