Meridian Health

Prior Authorization Requirements

Medicaid manual as well https://www.mimeridian.com/content/dam/centene/meridian/mi/pdf/PSM-MI-Provider-Manual-2022.pdf

Manual: https://corp.mhplan.com/ContentDocuments/default.aspx?x=FufBveTWnomftaMXIWBAorY/QcUu4wRObgoKdK0ty93wcfuDWdTxbTzbfhv5RqXvoYesivEyqSCnKAmOpE8yTw==

Availity® Meridian  1-800-282-4548

Effective April 1, 2022, the fax numbers to submit authorization requests will change and are listed below:
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 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