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.
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.
Companion Guides
MDCH Companion Guide
This companion guide provides specific details on how Michigan Medicaid coverage information is handled in a 270/271 transaction.
HIPAA 270/271 Real-Time Web-Service
This web-service allows providers to submit individual eligibility requests using a single Date of Service (DOS) or DOS span. An immediate real-time response is made to each eligibility request.
HIPAA 270/271 Batch Web-Service
This web-service allows users to submit a batch file using a single DOS or DOS span and receive a response file within 24 hours. Typically, responses should be returned within an hour. Factors such as file size and number of files being processsed can slow response time.
Contact Information
Web-Service Support
Rocco Sansotta
rsansott@mphi.org
(517) 324-6091
EDI Transaction Support
Peter Mattarella-Micke
pmattare@mphi.org
(517) 324-6041
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