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Claim Billing Requirements

The following are the standard claims billing requirements for providers.  Meridian Health Plan follows the State Medicaid guidelines for claims payment.  Providers should refer to the State Medicaid Provider manual for more information.

Please follow these guidelines for claims submission to Meridian Health Plan:


  • Providers must use a standard CMS 1500 Claim Form or UB-04 Claim Form for submission of
    claims to MHP.
  • Providers must use industry standard procedure and diagnosis codes such as CPT, Revenue, HCPCS
    and ICD-9 when billing MHP.
  • Specialty physician claims should include a PCP referral form and/or a corporate prior authorization number for payment.
  • Lab claims must be submitted on a CMS 1500 or Illinois 2360 Form.

Submit all claims for payment to:


Meridian Health Plan
1001 Woodward Avenue, Suite 520
Detroit, MI  48226
Attn: Claims Department



If you are re-submitting a claim for a status or a correction, please indicate “Status” or “Claims Correction” on the claim.


Electronic Claims Submission


MHP is currently accepting electronic claims from the following clearinghouses:


The SSI Group
 800-880-3032
 www.thessigroup.com

WebMD (Emdeon)
800-845-6592 
www.webmd.com


Availity
800-282-4548
www.availity.com


Netwerkes
262-523-3600
 www.netwerkes.com


 RelayHealth
866-735-2963
www.relayhealth.com

PayerPath
877-623-5706
www.payerpath.com

The Payer Id # for the Contracted Vendors is: 13189


Meridian Health Plan may add new clearinghouses from time to time, so please contact Provider Services at 866-606-3700 to see if your clearinghouse partner is on the list.



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