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Q: What are the advantages of Health Plan of Michigan?

A: HPM maintains an administrative and organizational structure that supports a high quality, comprehensive care management program. HPM's approach and organizational structure ensures effective linkages between administrative areas including member services, provider support services, network development, quality improvement, grievance/complaint management, medical information systems (MIS), utilization and case management.

Health Plan of Michigan's size allows it to have substantial flexibility in its relationships with its providers and hospitals. HPM's management believes that practitioners should have as much freedom as possible to practice medicine. It is with this goal in mind that HPM has developed a nearly paperless authorization system including an online Managed Care System (MCS) for use by all contracted providers.

Health Plan of Michigan provides a wide range of both preventive and therapeutic health care services to its Medicaid population. HPM takes great pride achieving high standards regarding HEDIS measures and implements technically advanced actions to ensure its success.

Q: What is MCS?

A: Health Plan of Michigan has implemented an innovative Managed Care System (MCS), which allows online authorizations to be viewed, created and authorized by our PCPs, Specialists and Hospitals. In addition to referrals and authorizations, providers may view specific preventive health care services needed for their own patients, verify eligibility and status claims online. The MCS is a real time information system that all contracted providers have access to free of charge.

Q: How can I apply to HPM?

A: In order to assure and maintain a high level of medical care, all providers are credentialed by HPM. Appropriate contracts and applications are provided along with a questionnaire regarding office function, personnel and the potential capacity to service more enrollees. Both HPM and the State of Michigan require proof of licensure and appropriate malpractice insurance coverage. In the case of an agreement with a Physician Hospital Organization (PHO) or a Physician Organization (PO) that has already credentialed member providers, HPM will consider the option of delegating that responsibility to the PHO/PO.

To receive information on becoming a contracted Provider with Health Plan of Michigan, please contact our Provider Services Department at (888) 773-2647 or email kwalker@hpmich.com.

Q: What are my contract options as a health care provider in the HPM network?

A: Primary Care Providers: HPM contracts with primary care physicians on a fee for service basis, with quality bonus incentives in lieu of traditional full risk arrangements. This focus on quality instead of risk arrangements allows physicians to do what they do best...Treat Patients.

Specialist Providers: HPM values the relationship with our Specialist Providers and seeks to limit the amount of "red tape" whenever possible, especially with referrals and authorizations. HPM continues to guarantee claim payments to Specialist Providers within 30 days of receiving a clean claim for all authorized services provided to a member.

Hospital Providers: Communication is the key to all mutually beneficial relationships. In this regard, HPM makes every effort to partner with each contracted Hospital in coordinating the care of its beneficiaries. Hospital Providers can count on Health Plan of Michigan to help serve the members of their community with as little interference as possible. For more information see the links below.