Michigan Payer Configuration and Requirements Tables
The payer configuration table is a valuable resource to help you understand the specific requirements for each payer contract as they relate to the integration process. By referencing this table, you can ensure the correct configuration of payer contracts, maintain compliance, and streamline workflows. Use this topic as a quick reference to verify the scope of each payer’s requirements and to facilitate a smooth integration process.
A&D Home Health Care, Inc.
| Payer | A&D Home Health Care, Inc. |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Aetna Better Health Premier Plan HHCS
| Payer | Aetna Better Health Premier Plan HHCS |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Aetna Better Health Premier Plan PCS
| Payer | Aetna Better Health Premier Plan PCS |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | No Information |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
AmeriHealth - AAA Region 1-A (Detroit)
| Payer | AmeriHealth - AAA Region 1-A (Detroit) |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | No Information |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Area Agency on Aging 1B
| Payer | Area Agency on Aging 1B |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Area Agency on Aging Northwest MI
| Payer | Area Agency on Aging Northwest MI |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Area Agency on Aging of Western MI
| Payer | Area Agency on Aging of Western MI |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
AuSable Valley Community Mental Health
| Payer | AuSable Valley Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Barry County Community Mental Health
| Payer | Barry County Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Bay-Arenac Behavioral Health
| Payer | Bay-Arenac Behavioral Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Blue Cross Complete
| Payer | Blue Cross Complete |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
CareWell Services/R3BAAA
| Payer | CareWell Services/R3BAAA |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Centra Wellness
| Payer | Centra Wellness |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
CMH for Central Michigan
| Payer | CMH for Central Michigan |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
CMH of Clinton, Eaton and Ingham Counties
| Payer | CMH of Clinton, Eaton and Ingham Counties |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Community Mental Health of Ottawa County
| Payer | Community Mental Health of Ottawa County |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Copper Country Mental Health Services
| Payer | Copper Country Mental Health Services |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Detroit Area Agency on Aging
| Payer | Detroit Area Agency on Aging |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Detroit-Wayne Integrated Health Network
| Payer | Detroit-Wayne Integrated Health Network |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Easterseals/MORC
| Payer | Easterseals/MORC |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Genesee Health System
| Payer | Genesee Health System |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Gogebic Community Mental Health Authority
| Payer | Gogebic Community Mental Health Authority |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Gratiot Integrated Health Network
| Payer | Gratiot Integrated Health Network |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
HAP CareSource
| Payer | HAP CareSource |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
HAP CareSource - AAA Region 1-B
| Payer | HAP CareSource - AAA Region 1-B |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | No Information |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
HealthWest
| Payer | HealthWest |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Hiawatha Behavioral Health
| Payer | Hiawatha Behavioral Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Huron Behavioral Health
| Payer | Huron Behavioral Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Integrated Services of Kalamazoo
| Payer | Integrated Services of Kalamazoo |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Lapeer County Community mental Health
| Payer | Lapeer County Community mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Lenawee Community Mental Health Authority
| Payer | Lenawee Community Mental Health Authority |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
LifeWays
| Payer | LifeWays |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Livingston County CMH
| Payer | Livingston County CMH |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Macomb County Community Mental Health
| Payer | Macomb County Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
McLaren
| Payer | McLaren |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Meridian
| Payer | Meridian |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Meridian - AAA Region 1-C (TSA)
| Payer | Meridian - AAA Region 1-C (TSA) |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | No Information |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Milestone Senior Services
| Payer | Milestone Senior Services |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Molina
| Payer | Molina |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | No Information |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Molina CHCP
| Payer | Molina CHCP |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Monroe Community Mental Health Authority
| Payer | Monroe Community Mental Health Authority |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Montcalm Care Network
| Payer | Montcalm Care Network |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
NEMCSA
| Payer | NEMCSA |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Network 180
| Network 180 | |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Newaygo County Mental Health
| Payer | Newaygo County Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
North Country Community Mental Health
| Payer | North Country Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Northeast Michigan Community Mental Health
| Payer | Northeast Michigan Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Northern Lakes CMH
| Payer | Northern Lakes CMH |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Northpointe
| Payer | Northpointe |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Oakland Community Health Network
| Payer | Oakland Community Health Network |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
OnPoint
| Payer | OnPoint |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Pathways Community Mental Health
| Payer | Pathways Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Pines Behavioral Health
| Payer | Pines Behavioral Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Pivotal
| Payer | Pivotal |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Priority Health Choice
| Payer | Priority Health Choice |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Region IV Area Agency on Aging
| Payer | Region IV Area Agency on Aging |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Reliance Community Care Partners
| Payer | Reliance Community Care Partners |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Riverwood Center
| Payer | Riverwood Center |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Saginaw County CMHA
| Payer | Saginaw County CMHA |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Sanilac County Community Mental Health
| Payer | Sanilac County Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Senior Resources
| Payer | Senior Resources |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Shiawassee Health and Wellness
| Payer | Shiawassee Health and Wellness |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
St. Clair Community Mental Health
| Payer | St. Clair Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
State of MI Home Health
| Payer | State of MI Home Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | 7/1/2024 Billing Mandate |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Summit Pointe
| Payer | Summit Pointe |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
The Information Center
| Payer | The Information Center |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
The Right Door
| Payer | The Right Door |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
The Senior Alliance
| Payer | The Senior Alliance |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Tri-County Office on Aging
| Payer | Tri-County Office on Aging |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Tuscola Behavioral Health Systems
| Payer | Tuscola Behavioral Health Systems |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
United Health Care
| Payer | United Health Care |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
UPCAP Services, Inc.
| Payer | UPCAP Services, Inc. |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Upper Peninsula Health Plan
| Payer | Upper Peninsula Health Plan |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Upper Peninsula Health Plan - UPCAP
| Payer | Upper Peninsula Health Plan - UPCAP |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Valley Area Agency on Aging
| Payer | Valley Area Agency on Aging |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Van Buren Community Mental Health
| Payer | Van Buren Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Washtenaw County Community Mental Health
| Payer | Washtenaw County Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
WellWise Services/R2AAA
| Payer | WellWise Services/R2AAA |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
West Michigan Community Mental Health
| Payer | West Michigan Community Mental Health |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |
Woodlands Behavioral Healthcare Network
| Payer | Woodlands Behavioral Healthcare Network |
|---|---|
| 835s Availability | Not in Scope |
| Billing Required | Not Required |
| Communications Module Availability | Not Available |
| DX Code Provider/Payer Managed | Provider Managed |
| EVV Required | Required |
| Payer GPS Tolerance | 600ft |
| Missed Visits Required | Required |
| POC Compliance Required | Not in Scope |
| Rate Provider/Payer Managed | Provider Managed |
| Referring Physician Required | Not in Scope |