HIPAA 270/271 Transactions for Michigan Medicaid
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.
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
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)
Enroll as a Provider or Billing Agent in CHAMPS.
> Providers > 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.
Complete MPHI’s online registration form.
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.
EDI Transaction Support
to return to MIHealth.org
Send email to MedicaidEligibility@mphi.org with questions or comments about this web site.
Copyright © 2009 Michigan Public Health Institute - Interactive Solutions Group
Last modified: 2009/09/01