12/17/2025
Midlands Choice is focused on improving operational efficiency, optimizing claim repricing, and leveraging modern technologies such as electronic claims submissions. For nearly twenty years, Midlands Choice used the services of an outside vendor with a mailing address in another state to handle the receipt and processing of all medical claims submitted on paper from network providers. Currently more than 98% of claims that are repriced at Midlands Choice are submitted electronically.
Midlands Choice has transitioned its claims submission process to emphasize the importance of electronic submission in the 837 format for more efficient and accurate repricing. The 837 format is a HIPAA compliant electronic standard for health care claims that streamlines the process and replaces claims submitted on paper. Claims sent to the PO Box in Troy, Michigan were to be forwarded to Midlands Choice for review and handling, however some claims are being returned to the sender. The Midlands Choice EDI routing ID remains 47080.
It is recommended that providers use whichever clearinghouse is used for other networks and insurance carriers. Midlands Choice does have a relationship with the inbound clearinghouse Availity, that is able to accept claims from other clearinghouses and pass them on to Midlands Choice.
Sending claims to Midlands Choice on paper requires the manual keying of the claim into the claim system. In some instances (such as if all required information is not submitted) the claim will be rejected and sent back to the provider through the mail rather than electronically which increases costs. Secondary claims submitted with a primary explanation of benefits will be accepted for manual entry, however any claim received on paper that has no attachment or attachments that are not required by Midlands Choice for repricing may be returned to the provider to be submitted electronically.