Claims and Provider Reimbursements
The forms and information available here will help you file claims to the appropriate addresses and facilitate your reimbursements. If you need further information, please visit the Contact Us page for assistance.
Claims
Network providers may submit claims to:
University of Michigan Health Plan
PO Box 313
Glen Burnie, MD 21060-0313
Phone: 517-364-8432 or 877-275-0076
Or file electronically:
Payor ID: 37330
Payor Name: University of Michigan Health Plan
Non-network providers may submit claims to:
Zelis Healthcare
PO Box 247
Alpharetta, GA 30009
Phone: 800-860-1111
Or file electronically:
Payor ID: 07689
Payor Name: University of Michigan Health Plan
Non-Network Provider Reimbursements
Non-network providers are reimbursed in accordance with network leased pricing, as applicable, or per University of Michigan Health Plan's (UM Health Plan) Non-Network standard reimbursement schedules. In keeping with the Centers for Medicare and Medicaid (CMS) reimbursement methodologies for the region, UM Health Plan's Non-Network standard reimbursement schedules are a reasonable and customary charges standard. The plan may review and adjust these reimbursement schedules on a yearly or as market determines basis.
Provider Appeals
UM Health Plan has processes for documenting and responding to administrative complaints, including claim payment decisions. Claim payment disputes may be submitted in writing by mail or fax:
Provider Appeal Form
University of Michigan Health Plan
Attn: Provider Appeals
PO Box 30377
Lansing, MI 48909-7877
Fax: 517-364-8517
Attn: Provider Appeals
Appeals must be received within 90 days from the date of adverse determination and/or date the claim was processed. UM Health Plan will research all claim payment disputes and provide a response within 30 days of receipt.
Provider Check Schedule
The plan processes provider checks for all products every Monday and Thursday, as well as on the last business day of the month. If you have any questions regarding the check-writing schedule, please contact Provider Relations at ProviderRelations@UofMHealthPlan.org.
