Michigan practices run more billing playbooks under one roof than most states. Medicaid managed care plans each carry their own authorization thresholds and visit caps, commercial payers add their own visit limits, and auto no-fault injury care, historically one of the state’s richest payer categories, now reimburses against a fee schedule pegged to a percentage of the Medicare rate, with strict documentation standards. A practice treating Medicaid, commercial, workers’ compensation, and auto-injury patients together is running four distinct billing logics at once.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for Michigan practices of every specialty, built around the state’s actual payers and rules.
Michigan’s payer landscape
Michigan Medicaid is delivered through the Comprehensive Health Care Program, which enrolls members into competing Medicaid Health Plans, including Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Blue Cross Complete of Michigan, Priority Health Choice, McLaren Health Plan, HAP CareSource, Aetna Better Health of Michigan, UnitedHealthcare Community Plan, and Upper Peninsula Health Plan. Each plan has its own prior-authorization thresholds and visit caps, and plan availability varies by region.
Commercial coverage is led by Blue Cross Blue Shield of Michigan and Priority Health, alongside Health Alliance Plan (HAP), Aetna, Cigna, and UnitedHealthcare. Auto no-fault injury claims follow the post-reform fee schedule tied to Medicare rates, so the same timed units that clear a commercial claim must be documented and priced to the no-fault standard when the injury is auto-related.
What MedPlus RCM handles for Michigan practices
- End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
- Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
- Provider credentialing and enrollment. End-to-end enrollment with Michigan Medicaid Health Plans, commercial payers, and Medicare, plus re-credentialing maintenance.
- Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
- A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
- Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
We serve practices statewide, Detroit, Grand Rapids, Ann Arbor, Lansing, and the Upper Peninsula, across specialties including primary care, mental and behavioral health, cardiology, orthopedics, dermatology, and physical therapy.
Results Michigan practices can check
MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.
Frequently asked questions
How does Michigan Medicaid work?
Michigan Medicaid enrolls members into competing Medicaid Health Plans under the Comprehensive Health Care Program. Each plan, Meridian, Molina, Blue Cross Complete, Priority Health, McLaren, HAP CareSource, and others, has its own authorization rules and visit caps, and availability varies by region.
Do you work with Michigan Medicaid Health Plans?
Yes. We bill Meridian, Molina Healthcare of Michigan, Blue Cross Complete, Priority Health Choice, McLaren, HAP CareSource, Aetna Better Health of Michigan, UnitedHealthcare Community Plan, and Upper Peninsula Health Plan, as well as commercial and Medicare plans.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.
Get a free financial audit
Find out where your Michigan practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
