Forms
Attention - Physicians Health Plan (PHP) is now University of Michigan Health Plan (UM Health Plan). Documents published before this change may still have references to the PHP brand.
University of Michigan Health Plan (UM Health Plan) has all of our commercial provider forms easily accessible at a click of a button. Please choose the form from the list below that best fits your needs.
Attention Medicare Providers
The forms on this page are for commercial use only. Please review the instructions to access Medicare Advantage forms.
Appeals
Provider Appeal Form
Authorized Appeal Representative
NSA Open Negotiation Form
Claims
Claim Adjustment Request Form
Medical Records Submission Form
