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How to Become An E-Biller
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 in the Michigan Medicaid Community Health Automated Medicaid Processing System (CHAMPS) system.
A billing agent that submits Medicaid claims via electronic media must be authorized by MDHHS before submitting claims. Once the billing agent has completed the business-to-business (B2B) testing requirements and is authorized by MDHHS, the provider must authorize the billing agent to submit their claims. The authorization for submitting claims via electronic media must be submitted even if the provider is acting as their own billing agent.
New Billing Agents
All new Billing Agent enrollments must be completed utilizing the CHAMPS system. All providers who are associated to a Billing Agent will not be able to complete a new enrollment until the Billing Agent has been approved in CHAMPS. The use or storage of data on any system or servers outside of the United States is expressly prohibited pursuant to the State of Michigan and DTMB policy.
- CHAMPS Billing Agent Application Instructions
- Ramp Manager Access
- Submitting Electronic Files to MDHHS
CHAMPS Access Information
The CHAMPS Application resides within the Michigan Department of Health & Human Services (MDHHS) MiLogin website. In order to access CHAMPS, you will need to have a valid MiLogin account. To register for a MiLogin user ID and Password please visit https://milogintp.michigan.gov
For step-by-step instructions on how to complete the enrollment process in CHAMPS, view the documents on the Provider Enrollment Website.
Domain Administrator
The MILogin user who submits the Billing Agent Enrollment application becomes the Domain Administrator for that application. The Domain Administrator has the responsibility of assigning rights for all users within the organization to access the billing agent's file. Multiple Domain Administrators may be established for a single organization, but a separate application must be completed and approved for each administrator.
Domain Administrator Functions
- Quick Reference Guide
- Electronic Signature Agreement Cover Sheet MDHHS-5405- List the CHAMPS Provider ID for the billing agent enrollment to be given access to the billing agent profile.
- Electronic Signature Agreement DCH-1401
- For Domain Administrator step-by-step CORE password instructions
Provider Enrollment has established an email address for domain access requests. Please send all requests to MDHHS-DomainRequests@michigan.gov.
For any Billing Agent related questions, please get in touch with AutomatedBilling@michigan.gov.
B2B Testing
All Michigan Medicaid Billing Agents will need to complete the B2B Testing process to ensure proper submission of HIPAA-compliant transactions.
For further information please email MDHHS-B2B-Testing@michigan.gov
Instructions for Access to the CHAMPS B2B Test Environment
Testing Instructions
- 5010 270 ACA Test Instructions
- 5010 276 ACA Test Instructions
- 5010 837 Claims Test Instructions
- 5010 837 Encounter Test Instructions
Policy and Forms
Michigan Medicaid utilizes the HIPAA-compliant ASC X12 Version 5010 format for HIPAA transactions, except those with retail pharmacies. Pharmacy transactions must use the NCPDP standard. This standard applies to claims, payments, and enrollment electronic transactions.
Medicaid Provider Policy and Forms
Electronic Submissions Manual (ESM)
Resources
- COVID-19 Public Health Emergency (PHE) 2023 Benefit Changes
- Blue Cross Blue Shield of Michigan HIPAA 5010 Information
- BC3NP Electronic Billing Information
- Center for Medicare and Medicaid Services (CMS)
- CHAMPS Webpage
- CMS: Electronic Billing and EDI Transactions
- CMS: Introductory Overview HIPAA 5010
- Electronic Visit Verification (EVV)
- HIPAA Companion Guides
- Michigan Medicaid NCPDP D.0 Payer Specifications
- Medicaid Provider Manual
- MiLogin Portal
- Provider Enrollment
- Reason and Remark Codes
- SIGMA
- Training
- Workgroup for Electronic Data Exchange (WEDI)