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How long does it take to get approved for Michigan Medicaid?

In most cases, MDHHS has 45 days to make a decision after you apply. If MDHHS needs to make a disability determination as part of your application, it has 90 days to make a decision. If you are pregnant when you apply, MDHHS has 15 days to make a decision.

Is Healthy Michigan Plan the same as Medicaid?

The Healthy Michigan Plan is a Medicaid health care program through the Michigan Department of Health and Human Services (MDHHS).

What is a medication prior authorization?

Prior authorization requires the prescriber to receive pre-approval for prescribing a particular drug in order for that medication to qualify for coverage under the terms of the pharmacy benefit plan.

What are the different types of Medicaid in Michigan?

Michigan Medicaid health plans through Priority Health. Priority Health offers Medicaid, including MIChild, Healthy Michigan Plan and Childrens Special Health Care Services (CSHCS) plans for individuals and their families in Michigan.

How do I find a Medicaid provider in Michigan?

Medicaid / MIChild Provider Directory Our directory is updated weekly. Please contact our Customer Service department at 888-327-0671 (TTY: 711) for any questions you may have, including how to obtain information on a providers race or ethnicity.

Does Michigan Medicaid require prior authorization?

services beyond those ordinarily covered by Medicaid or needs a service that requires prior authorization (PA). In order for Medicaid to reimburse the provider in this situation, MDHHS requires that the provider obtain authorization for these services before the service is rendered.

How do you initiate prior authorization?

Prior authorizationsometimes called preauthorization or precertificationis a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

What qualifies a person for Medicaid in Michigan?

See if you qualify for the Healthy Michigan Plan. Are age 19-64 years. Have income at or below 133% of the federal poverty level* (about $18,000 for a single person or $37,000 for a family of four) Do not qualify for or are not enrolled in Medicare. Do not qualify for or are not enrolled in other Medicaid programs.

What documents are needed for Medicaid in Michigan?

What to bring to your DHS appointment Proof of Income. Pay Stub(s) from the last 30 days. Bank Statement from the last 30 days. Social Security awards letter. Tax Return. Unemployment letter. Social Security Number. Identification. Drivers License. State ID. Proof of Address. ID with current address. Utility Bill.

Whose responsibility is it to obtain prior authorization?

The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patients insurance provider. As mentioned in the How does prior authorization work? section above, this will then often prompt a time-consuming back and forth between the provider and payer.

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How long does it take to get approved for Michigan Medicaid?

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What is a medication prior authorization?

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Does Michigan Medicaid require prior authorization?

How do you initiate prior authorization?

What qualifies a person for Medicaid in Michigan?

What documents are needed for Medicaid in Michigan?

Whose responsibility is it to obtain prior authorization?

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Get the up-to-date MDHHS - Medicaid Provider Forms and Other Resources 2024 now

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The easiest way to edit MDHHS - Medicaid Provider Forms and Other Resources in PDF format online

See more MDHHS - Medicaid Provider Forms and Other Resources versions

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Got questions?

How long does it take to get approved for Michigan Medicaid?

Is Healthy Michigan Plan the same as Medicaid?

What is a medication prior authorization?

What are the different types of Medicaid in Michigan?

How do I find a Medicaid provider in Michigan?

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People also ask

Does Michigan Medicaid require prior authorization?

How do you initiate prior authorization?

What qualifies a person for Medicaid in Michigan?

What documents are needed for Medicaid in Michigan?

Whose responsibility is it to obtain prior authorization?

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