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BAM 435 4 of 5 PROVIDER MANAGEMENT BPB 2026-014 5-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Multiple Names and Addresses A situation may occur where the owner of the business or property requests that the payment be issued to and/or mailed to another individual or business. For energy and non-energy service providers, payments are issued to the individual or business enrolled in Bridges and mailed to the physical address, or the address entered in the mailing address section. The provider's SVC and Address ID in Bridges must match the SVC and Address ID in VSS to ensure the payment is sent to the correct address. Adding Eligibility Type(s) to Enrolled Providers A provider may offer more than one service type using the same provider ID number. Additional service types may be added at any time to a provider ID number. The Search Enrolled Provider inquiry is used to determine the current service types. CHANGES TO PROVIDER ENROLLMENT Updating Enrollment Information The provider must request changes to the provider file (for example, name or address) in writing. The request should include the new information, the provider's tax identification number and the provider ID number. Submit a completed DHS-2351-X, with the written request from the provider to PMU. All changes are completed by PMU. PROVIDER ENROLLMENT TERMINATION Provider Enrollment Terminations - Central Office All terminations are completed by PMU. When provider enrollment termination is needed, submit the DHS- 2351-X to PMU. Energy-related providers must submit their termination request on company letterhead or by completing the DHS-355.

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Official source

BAM 435 4 of 5 PROVIDER MANAGEMENT BPB 2026-014 5-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Multiple Names and Addresses A situation may occur where the owner of the business or property requests that the payment be issued to and/or mailed to another individual or business. For energy and non-energy service providers, payments are issued to the individual or business enrolled in Bridges and mailed to the physical address, or the address entered in the mailing address section. The provider's SVC and Address ID in Bridges must match the SVC and Address ID in VSS to ensure the payment is sent to the correct address. Adding Eligibility Type(s) to Enrolled Providers A provider may offer more than one service type using the same provider ID number. Additional service types may be added at any time to a provider ID number. The Search Enrolled Provider inquiry is used to determine the current service types. CHANGES TO PROVIDER ENROLLMENT Updating Enrollment Information The provider must request changes to the provider file (for example, name or address) in writing. The request should include the new information, the provider's tax identification number and the provider ID number. Submit a completed DHS-2351-X, with the written request from the provider to PMU. All changes are completed by PMU. PROVIDER ENROLLMENT TERMINATION Provider Enrollment Terminations - Central Office All terminations are completed by PMU. When provider enrollment termination is needed, submit the DHS- 2351-X to PMU. Energy-related providers must submit their termination request on company letterhead or by completing the DHS-355.