Medical Billing Services in Michigan
As a remote-first medical billing company serving Michigan practices statewide, MedPrecision pairs MI-specific payer expertise with AAPC-certified billing experts. Michigan Compiled Laws 500.2006(8) gives a health plan 45 days from receipt to pay a clean claim — all clean claims, not only electronic ones — and 30 days to tell the provider every known reason a claim is not clean. That notice tolls the 45-day clock until the provider responds, and a claim must be billed within one year of the date of service or discharge to count as clean at all. The section does not reach Medicaid claims processed under MCL 400.111i, workers' compensation, or administrative-services-only and cost-plus arrangements, so a self-funded employer plan is a different conversation. Blue Cross Blue Shield of Michigan anchors the state's commercial payer mix, so credentialing and contract terms matter for most Michigan practices, while the Healthy Michigan Plan and Michigan Medicaid managed care add plan-level authorization and filing rules on top. Our remote team builds Michigan workflows around those rules, with payer-level edits, plan portal workflows, and appeals tuned to how Michigan plans actually adjudicate.
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The Michigan Billing Landscape
Michigan's Medicaid program includes both traditional Medicaid and the Healthy Michigan Plan, the state's ACA expansion program. When the Michigan Department of Health and Human Services awarded its Comprehensive Health Care Program contracts on 8 April 2024, it described the Medicaid health plans as serving nearly 2 million Michigan residents across Medicaid and the Healthy Michigan Plan; the plans named across the state's ten prosperity regions are Aetna Better Health of Michigan, Blue Cross Complete of Michigan, HAP CareSource, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, United Healthcare Community Plan and Upper Peninsula Health Plan, whose award covers Region 1 alone. The five-year contracts took effect on 1 October 2024 and the awards are regional, so plan availability differs by county. Blue Cross Blue Shield of Michigan is the commercial carrier most Michigan practices contract with, which makes BCBSM credentialing and contract terms a practical prerequisite rather than an option; Priority Health and HAP are significant regional competitors. Michigan's prompt pay rule is 45 days for a clean claim under MCL 500.2006(8), with a 30-day defect notice that tolls the clock — there is no separate 30-day electronic deadline. The state's auto no-fault system historically created unusual billing dynamics for injury-related care, though the 2019 reforms changed that landscape. Beaumont Health (now Corewell Health), Henry Ford Health and Ascension Michigan are major health systems. Detroit's urban practices navigate high Medicaid volumes and uncompensated care, while northern Lower Michigan and the Upper Peninsula face rural access challenges. Michigan requires commercial telehealth coverage parity under MCL 500.3476, though not payment parity. The state's large manufacturing base means a substantial self-funded employer population whose plans sit under ERISA — and outside the prompt-pay section, which excludes administrative-services-only and cost-plus arrangements.
Who We Serve in Michigan
Our Michigan client mix skews toward solo practices, group practices, dme suppliers , plus home health agencies and telehealth providers. We work with providers in Detroit, Grand Rapids, Warren and across the rest of the state, all remotely.
Major Metros Served
What billing costs in Michigan
We publish one national rate card and bill Michigan practices on exactly the same terms as everywhere else — there is no regional markup and no quote-only tier below enterprise. You pay a percentage of what we actually collect, so if we do not collect, you do not pay.
| Practice size | Rate | Basis | Note |
|---|---|---|---|
| Solo practice | 7.0% | of monthly collections | Monthly minimum applies |
| Group practice | 6.0% | of monthly collections | Volume discounts available |
| Enterprise | Custom | tiered pricing | Scoped per engagement |
- No setup or implementation fee
- No per-claim charge
- No software fee and no markup on third-party costs — clearinghouse fees, postage and payer application fees are passed through at cost
- 12-month initial term, then month-to-month — 60 days' notice either way, no early-termination penalty
Payer Landscape in Michigan
Healthy Michigan Plan and Michigan Medicaid managed care routes members through Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice and 3 more plans, each with its own authorization rules and fee schedule. On the commercial side, Blue Cross Blue Shield of Michigan, Priority Health, UnitedHealthcare drive the bulk of Michigan claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in Michigan run 365 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. Michigan's prompt-pay statute: Michigan Compiled Laws 500.2006(8) requires a health plan to pay a clean claim within 45 days of receipt, with simple interest at 12% a year on a clean claim paid late, and to notify the provider within 30 days of all known reasons a claim is not clean. The 45-day clock is tolled from the date that notice is sent until the plan receives the provider's response. A provider must bill within one year of the date of service or discharge for a claim to be clean. Subsections (7) to (14) do not apply to Medicaid claims covered under MCL 400.111i or to workers' compensation, and the statutory definition of health plan excludes administrative-services-only and cost-plus arrangements. Statute text verified against the Michigan Legislature's published Insurance Code on 17 September 2026.
Medicaid Program
Healthy Michigan Plan and Michigan Medicaid managed care
Managed Care Organizations
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
Michigan Compiled Laws 500.2006(8) requires a health plan to pay a clean claim within 45 days of receipt, with simple interest at 12% a year on a clean claim paid late, and to notify the provider within 30 days of all known reasons a claim is not clean. The 45-day clock is tolled from the date that notice is sent until the plan receives the provider's response. A provider must bill within one year of the date of service or discharge for a claim to be clean. Subsections (7) to (14) do not apply to Medicaid claims covered under MCL 400.111i or to workers' compensation, and the statutory definition of health plan excludes administrative-services-only and cost-plus arrangements. Statute text verified against the Michigan Legislature's published Insurance Code on 17 September 2026.
Michigan Billing Regulations & Compliance
The Michigan Department of Insurance and Financial Services (DIFS) sets the rules our Michigan billing workflows have to satisfy. Surprise billing in Michigan: Michigan does have a state surprise-billing law: Public Health Code sections 333.24501 to 333.24513, added by 2020 Public Acts 234 and 235 and effective 22 October 2020. Section 333.24509 requires a nonparticipating provider treating a nonemergency patient to give a signed written disclosure and a good-faith cost estimate on a set timetable, and a provider who fails to do so must submit the claim to the carrier within 60 days and accept as payment in full the greater of the carrier's median negotiated amount for the region and specialty or 150% of the Medicare fee-for-service rate, collecting nothing from the patient beyond in-network cost sharing. The carrier must pay that amount within 60 days. The federal No Surprises Act applies as well. Statute text verified 17 September 2026. Telehealth parity: Michigan Compiled Laws 500.3476, added by 2012 Public Act 215 and most recently amended by 2024 Public Acts 51 and 52 effective 2 April 2025, bars an insurer from requiring face-to-face contact for services appropriately provided through telemedicine and requires at least the same coverage for a telemedicine service as for the same service in person. It is a coverage rule, not a payment-parity rule, and telemedicine as defined there requires a HIPAA-compliant secure interactive audio or video system or store-and-forward messaging. Michigan Medicaid telehealth coverage is set separately in the Medicaid Provider Manual, so check the current policy for the service you bill. Statute text verified 17 September 2026.
State Insurance Regulator
Michigan Department of Insurance and Financial Services (DIFS)
Surprise Billing Protection
Michigan does have a state surprise-billing law: Public Health Code sections 333.24501 to 333.24513, added by 2020 Public Acts 234 and 235 and effective 22 October 2020. Section 333.24509 requires a nonparticipating provider treating a nonemergency patient to give a signed written disclosure and a good-faith cost estimate on a set timetable, and a provider who fails to do so must submit the claim to the carrier within 60 days and accept as payment in full the greater of the carrier's median negotiated amount for the region and specialty or 150% of the Medicare fee-for-service rate, collecting nothing from the patient beyond in-network cost sharing. The carrier must pay that amount within 60 days. The federal No Surprises Act applies as well. Statute text verified 17 September 2026.
Telehealth Billing Parity
Michigan Compiled Laws 500.3476, added by 2012 Public Act 215 and most recently amended by 2024 Public Acts 51 and 52 effective 2 April 2025, bars an insurer from requiring face-to-face contact for services appropriately provided through telemedicine and requires at least the same coverage for a telemedicine service as for the same service in person. It is a coverage rule, not a payment-parity rule, and telemedicine as defined there requires a HIPAA-compliant secure interactive audio or video system or store-and-forward messaging. Michigan Medicaid telehealth coverage is set separately in the Medicaid Provider Manual, so check the current policy for the service you bill. Statute text verified 17 September 2026.
Common Questions
Common questions about medical billing services in Michigan.
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Get a Free Billing AuditHow does MedPrecision handle Healthy Michigan Plan MCO billing?
Michigan awards its Comprehensive Health Care Program contracts by region, so the right question is which plans are contracted where your patients live. The Michigan Department of Health and Human Services award announcement of 8 April 2024 names Aetna Better Health of Michigan, Blue Cross Complete of Michigan, HAP CareSource, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, United Healthcare Community Plan and, in the Upper Peninsula, Upper Peninsula Health Plan across the state's prosperity regions. Each plan sets its own authorization protocols, fee schedule and filing requirements, so we verify the patient's plan and region before submission and configure edits, portal workflow and appeal routing per plan rather than once for Medicaid.
Can you handle DME billing for Michigan suppliers?
Yes. Michigan has a DME market with complex billing requirements spanning Medicare, Medicaid, and commercial payers. We handle prior authorization, HCPCS coding, proof of delivery documentation, and the recurring billing cycles that DME suppliers depend on for consistent cash flow.
What are Michigan's prompt pay requirements and how do you enforce them?
Michigan Compiled Laws 500.2006(8) requires a health plan to pay a clean claim within 45 days of receipt, and to tell the provider within 30 days of every known reason the claim is not clean. Two details decide whether the deadline is real on a given claim: the 45 days are tolled from the moment that defect notice goes out until the plan has your response, and the section does not reach Medicaid claims under MCL 400.111i, workers' compensation, or administrative-services-only and cost-plus arrangements. We track each claim against the clock that actually applies to it, pursue the statutory 12% simple interest where a clean claim is paid late, and use the complaint route the statute gives providers under subsection (12) — a form filed with the DIFS director — when a plan will not engage.
Does MedPrecision support specialty billing across Michigan?
Yes. Home health agencies in metro Detroit and specialty practices in Grand Rapids and Ann Arbor bill under the same Michigan payer rules but with different documentation burdens, so we build the workflow around the practice in front of us: home health billing tied to the assessment and plan-of-care documentation the payer requires, complex care-coordination claims, and multi-payer commercial and Medicaid submissions. Billing is delivered remotely, so what matters is the payer mix and specialty we are configuring for, not a local office.
What happens if a payer misses the Michigan prompt-pay deadline?
Michigan Compiled Laws 500.2006(8)(a) requires a clean claim to be paid within 45 days of receipt and gives the provider simple interest at 12% a year on a clean claim paid late. Under subsection (8)(b) the plan must notify you within 30 days of all known reasons the claim is not clean, and subsection (8)(c) tolls the 45-day clock while that notice is outstanding, so an early defect notice can move the deadline well past day 45. Subsection (8)(f) also requires the claim to be billed within one year of the date of service or discharge. We track every clean claim against these deadlines, flag stalled payments in our A/R reports, and file the complaint the statute provides for at the Michigan Department of Insurance and Financial Services when a plan defaults. Note the carve-outs: subsections (7) to (14) do not apply to Medicaid claims processed under MCL 400.111i, to workers' compensation, or to administrative-services-only and cost-plus arrangements. Statute text verified 17 September 2026.
How do I choose a medical billing company in Michigan?
Prioritize a billing company that already works with Healthy Michigan Plan and Michigan Medicaid managed care and the major commercial payers in Michigan — payer-specific edits and timely-filing windows are where most MI revenue leaks start. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Because billing is delivered remotely, a company's Michigan payer experience matters more than a local office address.
Services for Michigan practices
Specialties we bill for
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Services in Michigan
Specialties in Michigan
Other Locations We Serve
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