UM Health Plan Coverage has Ended. Please see below for additional information.

Submit your claims to the following address:

Global-Care
‍PO Box 247
Alpharetta, GA 30009-0247

Or submit your claim electronically by using the following information:

Payor ID: 07689
Payor Name: UM Health Plan

Your office will need to submit a Provider Information Update Form.

Review the latest Provider Manual.

Like many health plans, UM Health Plan has experienced significant financial losses over the past few years. After a thorough business and financial assessment, UM Health has made the difficult decision to close UM Health Plan.

This announcement comes after a comprehensive evaluation of the plan’s financial sustainability, market trends, and the evolving needs of our members.

We recognize the importance of affordable and reliable health care, and this decision was not made lightly. Despite significant efforts to maintain the plan, the increasingly competitive health insurance landscape, and the Centers for Medicare & Medicaid Services (CMS) changes to Medicare Advantage plans have made it unsustainable to continue offering the high level of service our members deserve.

UM Health Plan is closing. Member coverage has ended.

Providers were originally notified in Nov. 2024 of the decision to wind down the plan. Communications are also posted on the UM Health Plan website and provider portal. Ongoing communications will occur throughout the remainder of the year regarding closure and winddown activities.

Whether to accept deductible transfers from UM Health Plan is up to the new plan. If the new plan wishes to receive this information, they can request a report by sending an email to Customer.Service@UofMHealthPlan.org, within 30 days of the group’s or member’s termination with UM Health Plan.

Individual and group members: UM Health Plan will accept claims for processing as outlined in the providers participation manual and provider agreement. Electronic claims will be accepted through July 31, 2026.

Medicare members: UM Health Plan will accept in-network provider claims through June 30, 2026. Out-of-network provider claims can be submitted through Dec. 31, 2026.

In Network Payer ID

Commercial: 37330

Medicare: 83276

Out of Network Payer ID

Commercial: 07689  

Medicare: 83276

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All paper claims submitted must be received as outlined in the provider manual. We expect all claims to be received and processed by Dec. 31, 2026.

Commercial paper claims can be sent to:    

In Network

P.O. Box 313, Glen Burnie, MD 21060-0313

Out of Network

P.O. Box 247, Alpharetta, GA 30009-0247

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Medicare paper claims can be sent to:  

P.O. Box 7119, Troy, MI 48007

After July 31, 2026 – All commercial paper claims should be submitted to:

P.O Box 30377, Lansing, MI 48909-7877

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We encourage all providers to submit claims promptly to ensure prompt payment and processing. Claims not submitted within the terms of the participation agreement may be denied or rejected.

If you pay for health care services, it is best that requests for reimbursement be submitted within 90 days of the date of service. If UM Health Plan does not receive a claim within one year of the date of service, the health care services may not be covered. If your claim relates to an inpatient stay, the date of service is the date your inpatient stay ends.

If you are submitting a member reimbursement request for a pharmacy service after June 30, 2026, written notification of the claim must be given to the plan at the address below.

All medical reimbursements after Jan. 1, 2026, and pharmacy reimbursements after June 30, 2026, send to:

PO Box 30377
Lansing, MI  48909-7877

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It is important to keep UM Health Plan up to date on all provider information during the duration of time we are processing claims and for year-end tax purposes. The form for all updates and changes can be obtained on the UM Health Plan website, under Providers/Forms. You can send via email, fax, or mail at the locations indicated on the website.

1099s will be provided in accordance with applicable laws, which generally state 1099s must be sent by Jan. 31. For questions regarding your 1099s please email Finance@UofMHealthPlan.org.

Medicare members: The Medicare customer service call center will be available through May 31, 2027.

Individual and group members: The UM Health Plan Customer Service call center will be available through Aug. 31, 2026.

UM Health Plan is required to comply with all audit and regulatory requirements for any coverage year under contract. This will include audits of prior year(s) activity, which will require medical record validation. CMS has announced intent to complete Medicare Advantage RADV audits for coverage years 2018-2024, which will require UM Health Plan to obtain medical records from participating offices to support these CMS audit activities.    

Copies of the requested medical records must be received within 14 days of the request. Records may be provided in the following ways:

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Physical Mail

UM Health Plan Medical Record Request Team

P.O Box 30377

Lansing, MI 48909-7877

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Fax

517-364-8408

Attn: RADV Audit

Alternative Fax: 517-364-8460

Secure/Encrypted Email

QualityDepartment@UofMHealthPlan.org

Electronic

For flash drive or CD, please email pass codes to QualityDepartment@UofMHealthPlan.org

Onsite Review or Pick Up

Call or email to schedule

Providers are required to comply with all terms of their participation agreement with UM Health Plan that were in force at the time of the rendered service. As outlined in the providers participation agreement, payor shall have access to all records related to the obligations and health services being audited for ten (10) years following termination.  Copies of medical records must be sent within fourteen (14) days from the date the request is made.

Medical records should be sent as outlined in the medical request communication or as outlined below:  

Physical Mail

UM Health Plan Medical Record Request Team

P.O Box 30377

Lansing, MI 48909-7877

Fax

517-364-8408

Attn: RADV Audit

Alternative Fax: 517-364-8460

Secure/Encrypted Email

QualityDepartment@UofMHealthPlan.org

Electronic

For flash drive or CD, please email pass codes to QualityDepartment@UofMHealthPlan.org

Onsite Review or Pick Up

Call or email to schedule

In accordance with most provider participation agreements, the agreement specifies, “Provider will maintain adequate medical, ...administrative records related to Health Services rendered by Provider under this Agreement. Payor, .....upon reasonable notice and demand in writing or in person, shall have access to and the right to audit all information and records, and to make copies of such records at no charge, related to all of Provider and Participating Providers’ obligations and Health Services rendered by Participating Providers under this Agreement.”

Refer to your UM Health Plan participation agreement to determine if reimbursement for record retrieval is defined or if it may be charged to UM Health Plan. If your office utilizes a third-party service to retrieve, copy, and send records, you need to ensure your service provider is aware of the limits of the fee.

Individual and group: The UM Health Plan Customer Service team will be available through Aug. 31, 2026.  You can contact them at 800-832-9186.

Medicare: The Medicare provider service number is 844-529-3757. Medicare customer service call center is available through May 31, 2027.

UM Health Plan will continue to conduct audits and process claims, recoupments, overpayments, and adjustments throughout 2026 for services incurred during the coverage period.

ERA and EFT will continue through the Health Plans usual process through Aug. 31, 2026. After Aug. 31, 2026, all payment/processing will be completed via paper remittance and check.

Providers will have 60 days from the date a claim is processed to submit an appeal. All providers should submit claims promptly to ensure prompt payment and processing. Claims not submitted within the terms of the participation agreement may be denied or rejected.

UM Health Plan will send notice of final contract termination in accordance with the terms outlined in providers’ participation agreements. Providers are required to comply with all terms of their participation agreement with UM Health Plan that were in force at the time of the rendered service.

UM Health Plan is closing operations and terminated all health plan coverage.