Page 5

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

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

When it is necessary to end date a provider ID number due to multiple provider ID numbers, PMU will enter the correct provider ID number in the comment section of the Provider Service Details screen of the end-dated provider ID number. Send a DHS-2351-X to PMU to reactivate any end-dated provider ID number. Note: Energy-related service providers must complete and submit a DHS-355 to have their enrollment re-established. All Other Providers Home for the Aged provider enrollments must be terminated by PMU. When notification is received from public health that the license/certification is terminated, forward notification to PMU. Computer updates from Adult Foster Care licensing will automati- cally enter an end date for license closures for SLA, AFC and CI facilities. PROVIDER ENROLLMENT FILE Maintain forms used to enroll or change provider information on the provider enrollment file in a secure location. Also include any docu- ments with information upon which a provider enrollment or change is based.

loading…

Page 5

Official source

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

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

When it is necessary to end date a provider ID number due to multiple provider ID numbers, PMU will enter the correct provider ID number in the comment section of the Provider Service Details screen of the end-dated provider ID number. Send a DHS-2351-X to PMU to reactivate any end-dated provider ID number. Note: Energy-related service providers must complete and submit a DHS-355 to have their enrollment re-established. All Other Providers Home for the Aged provider enrollments must be terminated by PMU. When notification is received from public health that the license/certification is terminated, forward notification to PMU. Computer updates from Adult Foster Care licensing will automati- cally enter an end date for license closures for SLA, AFC and CI facilities. PROVIDER ENROLLMENT FILE Maintain forms used to enroll or change provider information on the provider enrollment file in a secure location. Also include any docu- ments with information upon which a provider enrollment or change is based.