Contact

Call Provider Services at 855-537-9746 (TTY 711), Monday - Friday from 8 a.m. - 8 p.m. with any questions.

Or, you can always contact your Provider Network Development Representative.

Email support is available at Providerhelp.MI@mhplan.com

Prior Authorization Form

MeridianChoice has created a universal form to improve efficiencies for the authorization process. The form is user friendly, and provides faster decision making and turnaround time.


SUBMIT A PRIOR AUTH

FAQ

faq


You’ve got questions, we’ve got answers. If there’s a question you can’t find the answer to on our website, call Provider Services at 888-773-2647 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.


How can I join the MeridianChoice Provider Network?


In order to ensure and maintain a high level of medical care, all providers are credentialed by MeridianChoice.

 

Appropriate contracts and applications are provided, along with a questionnaire regarding office function, personnel and the potential capacity to service more enrollees. Both MeridianChoice and the State of Michigan require proof of licensure and appropriate malpractice insurance coverage. In the case of an agreement with a Physician Hospital Organization (PHO) or a Physician Organization (PO) that has already credentialed member providers, MeridianChoice will consider the option of delegating that responsibility to the PHO/PO.

 

To receive information on becoming a contracted Provider with MeridianChoice, please contact our Provider Services department at 888-773-2647.


What are the member's cost-sharing (copays, coinsurance, deductible)?


Any amount a member pays towards their plan such as copays, coinsurance, and deductibles.

  • Copays: refers to a fixed dollar amount that the member is responsible for paying a Provider after the deductible
  • Coinsurance: means the share of the cost of a covered service that the member is responsible for paying a provider after meeting the deductible. Coinsurance is a percentage of the cost of services. For example, "60% coinsurance" means the member is responsible for 60% of the cost of the service after the deductible 
  • Deductible: the amount that the member must pay in any given policy year before MeridianChoice will begin paying for specific covered services. Deductibles are defined as a fixed dollar amount
    • For example: if the member's policy has a $2,000 deductible, MeridianChoice will not pay for any covered services until the member has paid $2,000 towards covered services for which the deductible applies during that policy year. Members may find their deductible on the Schedule of Copayments and Deductibles

You can view all of our SBCs by clicking here.


How do I determine member eligibility?


MeridianChoice has many plans to fit many budgets. However, individuals and households below certain incomes may qualify for premium tax credits or cost-sharing subsidies to buy a Marketplace plan. Click here to find out if you qualify for a premium tax credit or cost-sharing subsidy.


More FAQs


Click here to visit our full list of FAQs!


The National Committee for Quality Assurance has awarded MeridianChoice an Accreditation status of Accredited for service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement.

}

Page Last Modified: 4/5/2022 2:50:09 PM