Ingham Health Plan adjudicates claims according to the State of Michigan Medical Services Administration (MSA) policies and procedures. Please reference the Uniform Billing Guidelines, ICD‐10 Diagnosis, CPT and HCPCs code books, and Michigan Department of Health and Human Services (MDHHS) when submitting claims.
All claims are accepted and processed in house using claims processing software- Plexis Claims Manager. Professional claims must be submitted either by paper (CMS-1500(02-12)) or electronic (837 file format). Institutional claims must be submitted either by paper (CMS-1450(UB-04)) or electronic (837 File format). The health plan's electronic payer ID is 38343. Claims processed through Plexis are edited for many parameters, including Provider and Member eligibility, procedure validity, claim duplication, frequency limitations for services, and a combination of service edits. The health plan uses the Medicaid National Correct Coding Initiative (NCCI) policies and edits.
Paper Claims Submission:
Ingham Health Plan
PO Box 30125
Lansing, MI 48909
Once claims have been submitted to the health plan, an Explanation of Benefits is generated and mailed to providers or sent electronically (EFT). The Explanation of Benefits is also available electronically to providers by visiting the health plan’s portal.
Claim payments are sent two ways: Electronic Funds Transfer (EFT) or physical check mailed to provider's office.
Department of Health and Human Services
Medicaid Fee Screens
Centers for Medicare and Medicaid services
National Uniform Billing Committee (NUBC) Manual
National Uniform Claim Committee
Medicaid National Correct Coding Initiative (NCCI)