Michigan Health Plan Benefits

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 MDHHS 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.

1. Download the MPHI companion guide and determine which services your organization is interested in using.
   • Real-Time Web-Service (RESTful Web-Service)
   • Batch Web-Service (SOAP Web-Service)


2. Enroll as a Provider or Billing Agent in CHAMPS.
   • http://www.michigan.gov/providers > 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. For information on how to associate MPHI as a Billing Agent, please click here.



3. Complete MPHI’s online registration form.
   • Apply for Access


4. Allow 5-10 business days for MDHHS 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.

The MPHI Eligibility systems go down for maintenance during these maintenance windows.

• CHAMPS has maintenance on the third Saturday of the month from 6PM on Saturday to 6AM on Sunday.
• CHAMPS has a weekly maintenance window that occurs every Sunday from 8AM to 10AM.
• MPHI Eligibility services have a monthly maintenance window that occurs on the Saturday after the second Tuesday of the month from 6PM on Saturday to 6AM on Sunday.

Note: For more information on CHAMPS outages, please see their companion guide (above) or check on Medicaid Provider Alerts at All Alerts and Updates > > Assistance Programs > Medicaid > Go To Medicaid> Providers > Provider Alerts.

In addition to this FAQ page, you can also find further information about Health Plan Benefits website processes based on your role in the User Guide or Domain Administrator Guide.

If your question has not been addressed, or if you need further assistance, you can contact the appropriate Medicaid Eligibility Support teams through the information below.

(800) 292-2550
Contact for assistance with CHAMPS, billing, and claims.

MedicaidEligibility@mphi.org
(517) 324-6095
Contact for assistance with the MI Health Plan Benefits website or if you are unsure where to direct your inquiry.