Claims, Appeals, and Prior Authorizations

University of Michigan Health Plan (UM Health Plan), formerly known as Physicians Health Plan (PHP), is winding down operations as of Dec. 31, 2025. The closure has implications for the processing of claims, provider appeals, and prior authorizations for commercial members.

Claims: Please submit claims promptly, using the address on the back of the member ID card and in the Provider Manual. Timely submission will help ensure payments are issued smoothly while we prepare to close.

Provider Appeals: Providers have 60 calendar days* from the date of the adverse benefit decision letter or the date of the initial claim denial to submit an appeal using the Provider Appeal Form.

Prior Authorizations: Please follow appropriate protocols to request necessary authorizations before providing medical services. Providers are required to use EZ Auth/Referrals to submit authorization requests electronically.* You can access EZ Auth/Referrals through your provider portal.

*Providers are able to submit PA request forms for Self-Funded Members only. This policy does not affect Medicare.

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