Meridian Complete

Additional information

• Manual: https://corp.mhplan.com/ContentDocuments/default.aspx?x=FufBveTWnomftaMXIWBAorY/QcUu4wRObgoKdK0ty93wcfuDWdTxbTzbfhv5RqXvoYesivEyqSCnKAmOpE8yTw
• Provider Manual:  https://mmp.mimeridian.com/content/dam/centene/meridian/mi/pdf/MI-MMP-2022-Provider-Manual-FINAL.pdf
• Medicaid manual as well https://www.mimeridian.com/content/dam/centene/meridian/mi/pdf/PSM-MI-Provider-Manual-2022.pdf
• Pre Authorization link:  https://mmp.mimeridian.com/pre-auth-needed.html
• Availity® Meridian  1-800-282-4548

 Effective April 1, 2022, the fax numbers to submit authorization requests will change and are listed below:
Description and Fax number
Meridian Medicaid Assessments  833-341-2052
Meridian Medicaid Buy & Bill Jcode Requests  833-341-2049
Meridian Medicaid Concurrent Review  833-655-2188
Meridian Initial Admission / Face Sheets  833-467-1212
Meridian Medicaid Medical Records  833-431-3313

Meridian Medicaid Prior Authorization-ip/op  833-467-1237
Meridian Medicaid Transplant  833-920-4419
Meridian Medicaid Behavioral Health-Outpatient  833-655-2191

PROVIDER ADMINISTERED MEDICATIONS
For provider administered medications (also referred to as J-codes or biopharmacy), the prior authorization fax number will be 833-341-2049.
 

HEALTHY MICHIGAN PLAN HRA CHANGES
Healthy Michigan Plan (HMP) Health Risk Assessments (HRA) can be faxed to (833) 341-2052 (MER Fax) and the (517) 763-0200 (State Fax) or via the CHAMPS system. The previous 313 fax number will be retired as of April 1, 2022.
 

Other Provider Service Inquiries
For eligibility/benefit information, prior authorization, claim status or other claims-related inquires you may have, please contact your Provider Services Relations Representative or call Meridian Provider Services at 888-437-0606 (TTY 711) Monday through Friday 8 a.m. to 6:30 p.m.

MI Claim Payment Disputes (Related to untimely filing, incidental procedure, unlisted procedure code)

Meridian
Attn: Claims Payment Disputes Department
PO Box 8080
Farmington, MO 63640-8080

MI Claim Appeals (Medical) (Medical necessity, authorization denials, and benefits exhausted)

Meridian
Attn: Claims Appeals Department
PO Box 8080
Farmington, MO 63640-8080

Provider Appeals
Provider appeals (Medical Necessity Authorization Denials) will no longer be accepted via fax for dates of service 4/1/2022 and onward. Provider appeals must be submitted to the following address for review.

Fax Submission for all other Appeals — Please include pertinent clinical documentation with the request. Michigan Medicare Type of Request Fax Number Inpatient Admissions 1-844-930-4390 Post-Acute Admissions 1-844-930-4390 Pre-Service Standard Requests 1-844-930-4389 Pre-Service Expedited Requests Phone Number 1-855-323-4578 Part B Drug 1-844-930-4394 3. Phone Submission Michigan MeridianComplete: 1-855-323-4578

Meridian
ATTN:  Claims  Provider Appeals Department
PO Box 8080
Farmington, MO 63640-8080

Meridian Complete Duals (Medicare)

PO Box 3060

Farmington, MO 63640

Meridian Complete (Medicaid)

PO Box 4020

Farmington, MO 63640

Meridian has shared some additional phone numbers for offices to utilize if they are finding issues thru the provider portal in obtaining authorizations. 

Meridian Complete:

• Expedited Requests: Call 1-855-323-4578
• Requests: Fax 1-844-930-4389
• Concurrent Requests: Fax 1-844-930-4390
• All Medicare Part B Drug Requests: Fax 1-844-930-4394
• Expedited Requests: Call 1-855-323-4578
• Standard Requests: Fax 1-844-930-4389
• Transplant Requests: Fax 1-833-733-0318