Claims and Billing

Providers may submit claims to Upper Peninsula Health Plan (UPHP) in two ways:

1. Electronically – UPHP encourages all providers to submit claims electronically via the UPHP Claims Portal. Within the portal, users can also check the status of a claim, or submit a claim inquiry. Simply register for an account to get started. Use the National Electronic Insurance Code 38337.
2. Paper (Hard Copy) – Paper claims should be mailed to:

Upper Peninsula Health Plan
853 West Washington Street
Marquette, MI 49855

Handwritten claim forms are not accepted. If submitted, they will be returned. All claims must include the provider’s National Provider Identifier and be submitted on either of the following forms:

• Professional Claims – CMS 1500
• Facility Claims – UB-04

Electronic Reimbursement
UPHP works with Change HealthCare to provide Electronic Funds Transfer (EFT). Enrollment information for EFT can be found at  Medical & Hospital EFT Enrollment Forms.

Questions?
For assistance logging into UPHP Claims Portal, please contact the UPHP Helpdesk  at (906) 225-6811.

For questions regarding claims, contact UPHP Claim Services at UPHPClaimServices@uphp.com or call (906) 225-7746.

Frequently Asked Questions and Information Regarding Claim Payments and Submissions

UPHP billing policies are health-plan-specific policies that outline the guidelines and requirements for reimbursement of specific claims.

• Emergency Department Professional Visit Leveling
• Aquatic Therapy Policy
• Medical Nutrition Therapy
• Eyecare and Eyewear Billing Policy V4
• FQHC, RHC, THC Billing Policy
• Medicaid DME Manually Priced Codes
• Medicare DME Billing Policy
• Swing Bed Billing
• EMS Lift Assist
• Medicaid Mental Health Assessments
• Hospital Readmissions
• DRG Validation and Outlier Reviews