Provider Manuals, Forms and Resources
Michigan Complete Health Address Change Notice
Effective January 1, 2021 Michigan Complete Health is changing our address and moving our office from Troy to Detroit. This change is being instituted to reflect the health plan’s growth, enhanced role within managed care and to further our mission of transforming the health of our community one person at a time.
Our new address as of January 1, 2021 is below:
Michigan Complete Health
1 Campus Martius, Suite 700
Detroit, MI 48226
Should you have any questions, please contact the Provider Relations team at 844-239-7387 or email contracting@michigancompletehealth.com.
Reference Materials
- 2020 Provider Manual (PDF)
- Provider Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Balance Billing Quick Reference Guide (PDF)
Credentialing and Update Forms
- Physician Credentialing Application (PDF)
- Facility Credentialing Application (PDF)
- Provider Directory Demographic Survey (PDF)
- Provider Change Form (PDF)
Medical Management
- Prior Authorization Form Inpatient (PDF)
- Prior Authorization Form Outpatient (PDF)
- Formulary Consistency Notice (PDF)
- Prescription Drug Coverage Determination Form (PDF)
- NIA FAQ's (PDF)
- NIA Presentation (PDF)
Quality
- HEDIS Guide (PDF)
- Quality Assessment and Performance Improvement Program Description (PDF)
- How to Access Daily Care Gaps on the Availity Portal (PDF)
- Clinical Practice and Preventive Health Guidelines (PDF)
- 2020 Patient Rewards Program (PDF)
Training
- Secure Portal Authorization Tool Training (PDF)
- 2021 CMS Mandatory Trainings (PDF)
- 2021 Model of Care Provider Training (PDF)
Other
- 2019 Report Card (PDF)
- Caregiver Journal (PDF)
- Opioid Potentiators Memo (PDF)
- Jimmo v. Sebelius Settlement Agreement (PDF)
- Jimmo v. Sebelius Summary of Questions (PDF)
- Secure Portal Account (PDF)
- PaySpan – EFT and ERA Web Based Solution (PDF)
- Provider Claim Dispute Form (PDF)
- CLIA Phase II (PDF)
- New Electronic Prescription Drug Prior Authorization Tool (PDF)