UPHP Request to Contract

Information Update Form

Provider Group Information Update Form

W9

ADA Attestation Form

CSHCS Attestation Form

CHAMPS

To enroll in CHAMPS or if you have questions, please contact by phone 1-800-292-2550 or visit MILogin – Login (michigan.gov) online.

Or Provider Enrollment (michigan.gov)

MI Medicaid Fee Schedule

https://www.michigan.gov/mdhhs/doing-business/providers/providers/billingreimbursement/information-specific-to-different-providers

EFT Enrollment

At this time, UPHP is processing payment in paper format only but more to come on EFT Enrollment.

UPHP Assist Provider Portal

By having access to the UPHP Assist Provider Portal, you will be able to view member current and historical coverage, view member claim details, EOPs, and benefit accumulators, view member ID cards, as well as view and submit prior authorizations. To get started, please visit:

https://www.uphp.com/provider-login/

If you are having issues with the portal, please contact our Help Desk at 906-225-6811 or email at Help Desk HelpDesk@uphp.com

Link 4: Commercial Company Information
Lines of Business offered through UPHP.
UPHP Medicaid https://visibiledi.com/uphp/Home/Login
UPHP MI Health Link https://visibiledi.com/uphp/Home/Login
Cigna Cigna for Health Care Professionals
First Health Claims information (firsthealth.com)
Cofinity/Commercial Humana Claims information (firsthealth.com)
Aetna Commercial, Aetna Funding Advantage, Aetna Medicare Advantage
Electronic claims | Aetna
Availity: EDI Clearinghouse, Revenue Cycle Management, Provider Portal
www.Availity.com/aetnaproviders
HAP Sign On (hap.org)
Health EOS (Multiplan) Home (multiplan.com)
Humana Medicare Advantage Availity Essentials Portal Registration
Northcare (BH only) https://visibiledi.com/uphp/Home/Login
Priority Welcome, Providers | Priority Health
United Provider portal registration | UHCprovider.com

Counties Served

The 15 counties of the Upper Peninsula of Michigan are Keweenaw, Houghton, Ontonagon, Gogebic, Baraga, Iron, Marquette, Dickinson, Menominee, Delta, Alger, Schoolcraft, Luce, Chippewa, and Mackinac.

Limited License Providers

If you submit an application to us for the provider, they will be listed as limited licensed until they become fully licensed. We do recommend that you register the limited licensed provider in CHAMPS and enroll them with UPHP because then when they become fully licensed, they will better prepared to bill right away.

5.1 NONENROLLED PROVIDERS Professional services provided by limited licensed psychologists (except as noted in Section 333.18223 of the Public Health Code), social workers, professional counselors, marriage and family therapists or student interns are covered but must be performed under the supervision of an enrolled, fully-licensed provider of the same profession. Individuals who meet Michigan licensure/certification requirements for social workers and psychologists may provide services.

Social Worker An individual who possesses Michigan licensure as a master’s social worker, or Michigan licensure as a bachelor’s social worker, or has a limited license as a bachelor’s social worker or master’s social worker. Limited licensed social workers must be supervised by a licensed MSW (MCL 333.18501 – 507).

The name of the student intern would not be on the claim and a modifier would not be required.

Provider Site Visits

We reach out set up an appointment to visit the clinic as part of our requirement from the State of MI. We would specifically be looking to make sure that the clinic is in accordance with the state’s ADA standards. We would also collect a sample of medical records (the auditor will send the list a day or two prior to the visit) as well as doing the tour of the facility.

Quarterly Verifications

UPHP must maintain accurate provider data and directories.  This safeguards those who rely on directories to make informed decisions about their health care.  Identifying and sharing accurate provider data helps UPHP best serve our network providers and members.

Your practice’s current provider information is attached and sent via email to be verified quarterly.  If any of the information is incorrect, please reply to the email with the updated information and effective date.  Be sure to notify UPHP of any listed provider(s) who no longer practice at your location with their termination date.

If this information is correct, please consider reviewing with your team and keeping this document in your reception area for easy reference.

Please note that you can notify UPHP at anytime of any changes.