Provider Information

Claims & Eligibility Portal

Providers can submit and status claims,
as well as verify member eligibility.

There are three ways providers may submit claims to UPHG. However, we encourage all providers to submit claims via electronic data interchange (EDI) or online portal for a more efficient and cost-effective process.

    • UPHG Claims Portal:  Providers may submit claims using a secure online portal.  Users can also check the status of a claim or submit a claim inquiry. For assistance logging into the claims portal, contact UPHG Customer Service at 1-877-704-9223.
    • Clearing House: Providers may submit claims using their preferred clearinghouse and National Electronic Insurance Code 37324.
    • Paper (Hard Copy) – Providers may submit paper claims by mail to:


Upper Peninsula Health Group
853 W. Washington Street
Marquette, MI 49855

CLAIMS FORMS

All claims must include the provider’s National Provider Identifier (NPI) and be submitted on the following forms:

    • Professional Claims – CMS 1500
    • Facility Claims – UB-04
    • Dental Claims – J430

Handwritten claim forms are not accepted. If submitted, they will be returned.

CLAIM & ELIGIBILITY PORTAL AUTHORIZED USER VERIFICATION FORM

Complete the UPHG Claims Portal Authorized User Verification Form to request access to the Claims & Eligibility Portal. Completed forms should be sent to UPHG via fax or email.

Questions regarding the form and access issues should be directed to the UPHG Help Desk by emailing the above address or by calling 877-704-9223.

PRIOR AUTHORIZATION FORMS

UPHG does not currently require or provide prior authorization. Providers may call 877-704-9223 with questions regarding prior authorization or benefits.

UPHG must have a W-9 on file for each provider for each service location before claims can be paid.  Please send your W-9 to UPHG prior to submitting a claim.  If multiple billing NPIs remit to the same legal payee, you may include one W-9 with a listing of the following for each payee.

• NPI
• Payee Name / DBA Name
• Remittance Address

Please mail forms to:

Attn: Finance
Upper Peninsula Health Group
853 W. Washington Street
Marquette, MI 49855

For claim status and other claim-related questions, please contact UPHG’s Claim Services department by phone at 1-877-704-9223 or by email at UPHGclaimservices@uphealthgroup.com. For all other questions, please call Customer Service at 1-877-704-9223.