About
MPHI is now able to accept Real-Time/Batch HIPAA 270/271 transactions from all Providers, Billing Agents, and Clearinghouses registered with CHAMPS.
These services are provided on behalf of MDCH and are available free-of-charge.
Coverage Information
The following data is provided directly from the CHAMPS Eligibility and Enrollment Subsystem.
- Benefit Plan ID and additional provider information returned in the 2120C loop, if applicable.
- Beneficiary Address data.
- Medicaid Health Plan (MHP) Primary Care Physician (PCP), including the PCP name, telephone number, and National Provider Identifier (NPI). (Note: Data provided only if the date of service is the current date.)
- Third Party Liability (TPL), including the Payer Name, Payer ID, Coverage Type Code, Group Number, and Policy Number.
- CSHCS restriction data, including qualifying diagnosis code(s) and authorized provider data if the provider submitting the inquiry is authorized for the date of service.
- Pending Eligibility data (Medicaid-related programs only).
- Other information including, Current County of residence, DHS Case Number, DHS County Office, and DHS Local Office number.
- Support for DSH inquiries beyond one year of prior coverage
Note: DSH related eligibility inquires are only available to providers enrolled under the FAO enrollment type that have completed the DSH question under the "Manage Provider Checklist" (in the CHAMPS-PE subsystem) and have received approval from MDCH
Enrollment Process
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Download the MPHI companion guide and determine which services you’re organization is interested in using.
- Real-Time Web-Service (RESTful Web-Service)
- Batch Web-Service (SOAP Web-Service)
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Enroll as a Provider or Billing Agent in CHAMPS.
Note: Clearinghouse vendors need to enroll as a Billing Agent and be associated with the Providers they represent to be able to submit HIPAA 270/271 transactions on their behalf.
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Complete MPHI’s online registration form.
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Allow 5-10 business days for MDCH to review your application. MPHI will contact you with login/password and instructions on how to use our HIPAA 270/271 web-services once your application has been approved.
MDCH Companion Guide
This companion guide provides specific details on how Michigan Medicaid coverage information is handled in a 270/271 transaction.
MPHI Companion Guide 5010 v1.2
This companion guide details how to submit transactions to MPHI's Medicaid Clearinghouse. Details for both the Real-Time and Batch Web-Services have been consolidated into the same document.
Contact Information
Enrollment Support
Support Desk
MedicaidEligibility@mphi.org
(877) 816-0737
Web-Service Support
Peter Mattarella-Micke
pmattare@mphi.org
(517) 324-6041
EDI Transaction Support
Peter Mattarella-Micke
pmattare@mphi.org
(517) 324-6041
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