09/19/2023

Health Alliance Plan

Health Alliance Plan Managed Care Committee Member

April Danish, CHONC - Newland Medical Associates

New Payer ID for Medicaid Claims Coming Soon!
Effective for dates of service Oct. 1, 2023, and forward, HAP CareSource (formerly HAP Empowered Medicaid) will have a new payer ID: Availity clearinghouse Payer ID - MIMCDCS1

Please be sure to contact your clearing house and give them the new payer ID for HAP CareSource Medicaid only (formerly HAP Empowered Medicaid) beginning Oct. 1, 2023.

Important! This change does not affect HAP or HAP Empowered MI Health Link claims.

For more information on HAP CareSource please see the press release. 

Medical and Behavioral Health Level 1 Appeals Update
Effective November 1, 2023, all contracted and non-contracted practitioners and providers have sixty (60) calendar days from either the date of the HAP issued denial letter or claims denial, whichever comes first, unless otherwise indicated in the provider contract. Please see details below.

Level 1 appeals

• Practitioners and providers have sixty (60) calendar days from either the date of the HAP issued denial letter or claims denial, whichever comes first, unless otherwise indicated in the provider contract.
• All appeals will be processed within 60 days of receipt.
• All cases that do not contain clinical information will be denied. Reconsiderations require providers to file a Level 2 appeal.
• All cases initially denied for no prior authorization will be reviewed and if no authorization is on file, the case will be denied for no prior authorization.

You can find more information on our appeals process in the HAP Billing Manual. Log in at hap.org and select Billing Manual under Quick Links.

HAP Empowered and CareSource Finalize Joint Venture
It’s official! HAP Empowered is teaming up with CareSource, a nationally recognized managed care organization. Our partnership will provide even better health care and create better health outcomes for Medicaid beneficiaries in Michigan.

New Name and Resources
Starting October 1, 2023, HAP Empowered Medicaid plans will become HAP CareSource plans. This includes members in Medicaid, MIChild, Healthy Michigan Plan, and Children’s Special Healthcare Services plans. Members in HAP Empowered MI Health Link plans are not included in this partnership yet.

There will be a dedicated website, a secure portal for Medicaid business, new member ID cards, and more.

Member Benefits
Your Medicaid patients can count on:

• A Strong Local Presence with a National Reach. Getting personalized care with added national resources.
• A Large Network. Doctors, hospitals, and specialists who care about your patients.
• Care Coordination. Helping your patients navigate the complex health care system and get the right care at the right time.
• Care Beyond Health. Having a job, healthy food, and housing impacts health. Our new programs will focus on these social drivers of health.
• Commitment to Quality. A shared value that all members get high-quality health care.

Please watch the provider newsroom for details on doing business with HAP CareSource.