Access AICM – Michigan referral forms and resources for clients, families, attorneys, healthcare providers, and other professionals involved in Case Management.
Access the forms and documents needed to begin and support independent Michigan Auto No-Fault Case Management services.
Attorneys, healthcare professionals, individuals and families can submit a secure referral to AICM – Michigan for independent Michigan Auto No-Fault Case Management.
Start a Referral
Review AICM – Michigan's Case Management service agreement, including the terms, responsibilities and expectations associated with our independent services.
View Service Agreement
Complete this authorization to allow AICM – Michigan to obtain and share protected medical and health information needed to coordinate Case Management services and communicate with the treatment team.
Open Fillable Form
Provide important information about the client, Motor Vehicle Crash, insurance claim, injuries, medical providers and current services to help AICM – Michigan begin coordinating care.
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Review the information and documents that help AICM – Michigan quickly evaluate a referral, confirm coverage and begin coordinating Michigan Auto No-Fault Case Management services.
View Referral Checklist
Complete the application for Personal Injury Protection (PIP) benefits through the Michigan Assigned Claims Plan when an eligible injured person does not have an applicable No-Fault insurer.
Open Fillable Application