FAQs
Medicaid Provider FAQ
How Do I Submit a Claim?
Visit our Billing & Payments page for more information.
Where Can I Find the Provider Manual and Information on Prior Authorizations?
You can find the Provider Manual along with the Claims Provider Manual on our Provider Manual Page. You can find our Prior Authorization and Referral Guide on our Documents and Forms page under Medical Referrals and Authorizations.
How Do I Request Claim Status?
Meridian is happy to assist providers with claim status!
Providers are able to check claims status using our self-service interactive voice response tool by calling Customer Service at 888-437-0606 (TTY 711). Please have the NPI, claim number, and member information available when using this tool.
Providers and billers can also access claim status using the Provider Portal located on the Login page for providers on mimeridian.com.
What Are the Advantages of Becoming a Meridian Provider?
Learn more about what Meridian can do for you on our Why Meridian? page.
How Can I Become a Meridian Provider?
To become a contracted Meridian provider, visit Become a Provider on mimeridian.com.
What Are My Contract Options as A Health Care Provider in The Meridian Network?
- Primary Care Providers
Meridian contracts with Primary Care Providers on a fee-for-service basis, with quality bonus incentives in lieu of traditional full risk arrangements. Our focus on quality, instead of risk, allows physicians to do what they do best: treat patients. - Specialist Providers
Meridian values the relationship with our specialist providers and seeks to limit the amount of "red tape" whenever possible, especially with referrals and authorizations. Meridian continues to provide prompt claims payment to specialist providers. - Hospital Providers
Communication is the key to all mutually beneficial relationships. In this regard, Meridian makes every effort to partner with each contracted Hospital in coordinating the care of its beneficiaries. Hospital providers can count on Meridian to help serve their communities with as little interference as possible.
As A Participating Meridian Provider, Do I Have to Accept New Patients?
No. Providers can choose whether or not they will accept new patients.
If I Become a Contracted PCP, Can I Limit the Amount of Patients I Accept?
Yes, contracted PCPs with Meridian are given complete control over their panels. They can determine the number of patients they will accept, as well as any gender or age restrictions.
Who Should I Contact If I Have Questions Regarding My Provider Affiliation Status or General Questions Related to Meridian?
Please review the Provider Portal or call Meridian Provider Services at 888-773-2647 (TTY 711).
How Can I Check a Member's Eligibility? Members will receive a Meridian ID card for each member of their family that is enrolled. Providers can also check member eligibility through the Meridian Provider Portal, or through MI Login/ CHAMPS. To learn more about CHAMPS, contact MDHHS or visit www.michigan.gov/medicaid.
Do PCPs Need a Referral to See a Meridian Member Not Assigned to Their Panel?
No. In-Network PCPs do not need a referral to see a Meridian member, even if the member is not assigned to them.
Do Specialists Need a Referral to Provide Services to Meridian Members in The Office?
No. In-network specialists do not need a referral to provide services in their offices.
Can PAs, NPs, And APNs Contract with Meridian?
PAs, NPs, and APNs are able to contract directly with Meridian Health Plan.
Does Meridian Pay the Provider Add-Ons that the State of Michigan Pays?
Yes. Meridian pays all of the provider add-ons that the state pays.
Do You Follow the State of Michigan Billing Guidelines?
Yes. Meridian follows the State of Michigan billing guidelines unless otherwise noted.
What Is the Provider Portal?
The Provider Portal is a secure, online tool that allows PCPs, specialists and hospitals to view and create online authorizations and referrals, view specific preventive health care services needed for patients, and verify eligibility and status claims online. The Provider Portal is a real-time information system available to all contracted providers free of charge.
Behavioral Health FAQ
Unlimited outpatient visits are available.
No.
No. Up to 5 hours of testing is permitted using either CPT code 96101 or 96102. The tests and measures must be rendered by full, limited-licensed, or temporary-limited-licensed psychologists.
No. Meridian reimburses for one "Psychiatric diagnostic interview examination" (CPT Code 90801) per year per provider group.
Call the Meridian Behavioral Health Department at 888-222-8041 to notify us of your evaluation. Our staff will coordinate the referral services with the member's CMH center.
After the initial assessment and for ongoing coordination after the 3rd visit by sharing the COTNF.
Referrals can be generated by accessing the provider portal or contacting Provider Services at 888-773-2647.