Appeal Fax Submission Details

Based on feedback received by our Provider Network team, we have updated the Appeal Process to include fax submission of Requests for Formal Appeals, in addition to online submission through the online portal, and mail submission.

Using our existing Appeal Form Cover Letter, you can now fax submissions the Michigan Medicaid Post-Service appeals intake at 833-592-0658, or to the Michigan MMP Post-Service Appeals intake at 833-957-0439. For your appeal to be processed via Fax please ensure the following is submitted:

• The claim number being appealed
• Appeal letter

To ensure your Appeal is processed as promptly as possible, we strongly encourage the use of the Appeal Form Cover Letter that corresponds to line of business the member is enrolled in. These cover letters are linked on the Bulletins page and on the Provider Documents and Resources page of mimeridian.com and mmp.mimeridian.com.

If you have any questions about this updated process, please reach out to your Provider Representative, or call
888-773-2647 (TTY 711).