Trusted Medical billing services in Michigan
SwiftCare Billing provides medical billing services in Michigan for practices that want fewer denials and faster payments. We bill WPS for Medicare, all nine Medicaid health plans, and Blue Cross Blue Shield of Michigan. Pricing starts at 3% of collections. Month-to-month, 30 days’ notice.
- 98.4% Clean Claim Rate
- 175+ Providers
- 50+ Specialties
- 12+ Years
Michigan medical billing at a glance
Medicaid program
Michigan Medicaid, run by the Department of Health and Human Services (MDHHS)
Medicaid enrollment
About 1.76 million in the nine health plans (January 2025), including 557,036 on the Healthy Michigan Plan
Medicaid health plans
Aetna Better Health of Michigan, Blue Cross Complete of Michigan, HAP CareSource, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, UnitedHealthcare Community Plan, Upper Peninsula Health Plan.
Provider enrollment and claims
CHAMPS
Medicare A/B contractor
WPS Government Health Administrators, Jurisdiction 8 (Michigan and Indiana)
Medicare DME contractor
DME MAC Jurisdiction B
Medicare timely filing
12 months from date of service
Medicaid timely filing
12 months for fee-for-service; plan limits vary (confirm each manual)
Largest commercial payer
Blue Cross Blue Shield of Michigan
Why does billing in Michigan take state-specific work?
Nine Medicaid plans, and a new dual-eligible program
Each of the nine plans has its own authorizations and claim edits. In January 2026, MI Coordinated Health started in select regions. It rolls Medicare and Medicaid into one plan for dual-eligible patients, and it goes statewide in 2027. A patient who used to bill two ways may now bill one. We check coverage before each visit.
No-fault auto claims pay by a fee schedule.
Michigan auto injury claims run through no-fault PIP. Since 2021, providers are paid up to 190% of Medicare for covered treatment, and 52.5% of 2019 charges when Medicare has no rate. Overdue benefits start at 30 days. Practices that billed old rates are leaving money on the table. We rebuild those claims to the schedule.
Forty-five days, then 12% interest
Michigan’s Prompt Pay Act requires health plans to pay a clean claim within 45 days. After that, simple interest of 12% a year applies. You get 45 days to fix a claim the plan calls defective. We watch both clocks.
Out-of-network at an in-network hospital
Michigan law pays out-of-network providers at in-network facilities the greater of the plan’s median in-network rate or 150% of Medicare. Non-emergency patients must get notice at least 14 days ahead. The federal No Surprises Act applies to self-funded plans. We sort claims by which rules cover them.
- Our Services
Our medical billing services in Michigan
Our physician billing services in Michigan cover the whole cycle, or any single step. That includes medical practice billing services, medical claims processing services in Michigan, and medical billing and coding by AAPC-certified coders. Think of us as Michigan medical billing solutions that sit inside your system, not on top of it.
We confirm which of the nine plans a patient is on, and whether MI Coordinated Health applies.
Codes checked against WPS edits and each plan’s rules
Claim submission
Claims scrubbed first, tracked until paid
Each denial logged by payer and reason, then the cause fixed
Claims past day 45 get chased, and interest owed gets claimed
Payments posted, statements patients can read
Requests tracked plan by plan
Outsourced medical claims management for Michigan healthcare providers
You hand us claims, we handle the follow-through. Eligibility, scrubbing, submission, denials, and A/R sit with one team and one named account manager. You get a monthly report on collections and denials.
Medical billing support services for independent physicians in Michigan
Independent doctors don’t have a billing department. Some have one person who’s also the front desk. We act as that department, third-party but not distant. You always know who’s working your claims.
Medical credentialing and payer enrollment in Michigan
A provider can’t bill until they’re enrolled. Michigan Medicaid requires every provider to be screened and enrolled in CHAMPS. Then you contract with each health plan separately. Our medical credentialing services handle all of it, including Blue Cross Blue Shield of Michigan and Medicare.
- NPI check and an attested CAQH profile
- Medicare enrollment through PECOS, processed by WPS
- Medicaid enrollment in CHAMPS
- Credentialing with each Medicaid health plan you choose
- Commercial plan applications
- Revalidation reminders
Payers we bill in Michigan
We bill Medicare, Medicare Advantage, Medicaid health plans, and commercial carriers like Blue Cross Blue Shield of Michigan. We also bill no-fault auto and workers’ compensation carriers. In Michigan, workers’ comp has its own fee schedule, and providers can’t bill the injured worker for the difference.
Here’s how the rules differ by payer:
| Payer type | Rule that changes your billing |
|---|---|
| Commercial health plans | Clean claim paid in 45 days; 12% interest if late (MCL 500.2006) |
| No-fault auto (PIP) | 190% of Medicare for covered care; 52.5% of 2019 charges otherwise; overdue after 30 days |
| Workers’ compensation | State fee schedule; no balance billing the worker |
| Out-of-network at in-network facility | Greater of median in-network rate or 150% of Medicare |
Comparing vendors? See how to compare medical billing companies in Michigan. Plenty of healthcare billing companies in Michigan make the same promises, so ask each one how they handle the rules above.
Medical specialties we bill for in Michigan.
We bill 50+ specialties. Michigan practices often come to us in family practice, paediatrics, mental health, physical therapy, chiropractic, and cardiology. Doctors who see auto accident patients benefit most from no-fault expertise.
EHR and practice management systems we work with
We support 80+ systems and work inside yours: Epic, athenahealth, eClinicalWorks, Tebra (Kareo), and AdvancedMD, among others—nothing to migrate. We connect to your clearinghouse and CHAMPS.
Where we work in Michigan
Detroit, Grand Rapids, Ann Arbor, Lansing, Flint, Kalamazoo, Troy, Warren, Traverse City, and Southfield, and the towns in between. SwiftCare Billing serves providers in all 50 states.
HIPAA-compliant medical billing services in Michigan
Billing means handling patient data all day. Here’s what to expect from any vendor, us included.
- A signed BAA. HIPAA requires a business associate agreement before a vendor touches your PHI (45 CFR 164.504(e)). We sign one first.
- Breach notice. A business associate must tell you about a breach without unreasonable delay, and within 60 days of discovery at the latest (45 CFR 164.410). Your BAA can set a shorter deadline, and we’d follow it.
- Limited access. Our U.S.-based staff sees what a billing task needs, not the whole chart.
- Your data stays yours. If you leave, your claims and patient accounts go with you.
Results Michigan practices can check
98.4% clean claim rate across SwiftCare Billing clients
Onboarding in 7 to 14 business days
Free audit report in 5 business days
Medical billing pricing for Michigan practices
Pricing starts at 3% of collections. Most practices land between 3% and 8%, depending on specialty, volume, and payer mix—no long-term contract. See pricing. Looking for reliable medical billing solutions for private clinics in Michigan? A free audit shows you real numbers before you commit to anything. And if you want a third-party medical billing company for Michigan medical practices, the audit is the lowest-risk way to start.
How onboarding works
1. Free audit of your recent claims, written report in 5 business days
2. Access to your EHR and clearinghouse
3. Enrollment check with WPS, CHAMPS, and each plan you bill
4. Fee schedule and contract review
5. Go-live in 7 to 14 business days, then monthly reporting
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Frequently asked questions
How much does medical billing cost in Michigan?
It starts at 3% of collections. Most practices pay 3% to 8%. A free audit gives you a quote based on your own claims, not a guess.
Which Michigan Medicaid plans do you bill?
All nine: Aetna Better Health, Blue Cross Complete, HAP CareSource, McLaren, Meridian, Molina, Priority Health Choice, UnitedHealthcare Community Plan, and Upper Peninsula Health Plan. We handle credentialing with each.
Who processes Medicare claims in Michigan?
WPS Government Health Administrators, as the A/B MAC for Jurisdiction 8. DME claims go to DME MAC Jurisdiction B. Medicare claims must be filed within 12 months.
How fast must Michigan health plans pay?
Within 45 days of receiving a clean claim. After that, 12% simple interest applies. You get 45 days to correct a claim a plan calls defective.
Can you bill no-fault auto claims?
Yes. We bill PIP to the Medicare-based fee schedule: up to 190% of Medicare for covered care.
Do you sign a business associate agreement?
Yes, before we access anything. HIPAA requires it, and it sets breach-notice terms.
Can you work inside our EHR?
Yes. We support 80+ systems, and you keep yours.
Talk to a billing team that knows Michigan Medicaid.
Please tell us which Medicaid plans and commercial payers you bill. We’ll review your recent claims and send a written report within 5 business days.