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.
Note: DSH related eligibility inquiries 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 MDHHS.
- 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)
- 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.
Companion & User Guides
Service Dates and Times
The MPHI Eligibility systems go down for maintenance during the CHAMPS maintenance windows.
- CHAMPS has maintenance on the second Saturday of the month from 6PM on Saturday to 9AM on Sunday.
- CHAMPS has a weekly maintenance window that occurs every Sunday from 8AM to 10AM.
Note: For more information on CHAMPS outages, please see their companion guide (above) or check on Biller "B" Aware at www.michigan.gov/mdhhs > Doing Business with MDHHS > Health Care Providers > Providers > Medicaid > Medicaid Alerts > Biller "B" Aware.