Submitting Paper Claims

To avoid delays in claim repricing:

• Use our online form for CMS-1500 claims.
• For paper claims, use current, standard claim forms (CMS-1500 and UB-04).  Claims on out-of-date or nonstandard forms will be returned for resubmission.  We do not accept handwritten claims.
• Follow CPT-4, ICD-9 and HCPCS coding standards.
• Refer to sample claim forms and recommendations at First Pass Success.
• Obtain the correct claim mailing address from the patient's medical identification card, from Employer/Group lookup (secure login required) or by contacting our customer service department.

When mailing claims to Midlands Choice, the address is:

Midlands Choice Claims P.O. Box 5809 Troy, MI  48007-5809