For Healthcare Providers:

Submitting Paper Claims

To avoid delays in claim repricing:

  • Use our online form for CMS-1500 claims. Submit CMS-1500 Claims Online 
  • 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 Claims on out-of-date or nonstandard forms will be returned for resubmission.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-10 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