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Detroit, MI 48202 (888) 564-5487oreviCore.com. 246 0 obj <>stream Questions about registration If you need assistance with the online application you can call the SoonerCare helpline at 1-800-987-7767 or visit your local . In this section, youll find numerous resources here that will help you serve our members. $/o|PXPXP,g3xE^-xGyYzza^X/:=2,,,,!o/03 Helping Developers create Next Generation Digital Experiences using Secure Innovative APIs Star Ratings are calculated each year and may change from one year to the next. Fees for a primary . This change was made to align with clinical coverage policies. Birth, Death, Marriage and Divorce Records. U Y@ (313) 664-8833, #3 (Monday through Friday from 8 a.m. to 5 p.m.) COVID-19 Public Health Emergency (PHE) 2023 Benefit Changes. For more information, see the guidelineshere. The benefit information provided is a brief summary, not a complete description of benefits. And it continues to grow. ]~k|d-Hi:A:VaS),_.7(G*+T! >*wD'WXMtb6k4X(yUf5h{",].J`P)4~=$"EVB`wMG? yYA>s a[@jt5SF)A|zpV3n1mC!?n>W{1chcF*16ND-tCFMx;jlx|p(Pq/ Tell Your Story #MySoonerCare. 3 Heritage has the BEST Customer Service Staff Ever!!! The resources you need to provide top-notch care. It is not intended to replace the legal source. Alliance Medicare Supplement: #current year# Health Alliance Plan of Michigan. When your annual out-of-pocket costs exceed $6,350. Report a compliance concern or potential fraud, waste or abuse. For a complete list of services that require authorization,log inandselect Procedure Reference Lists under Quick Links. 855-699-6694, Minnesota Uniform Practitioner Change Form, Meeting the Challenges of Opioids and Pain, Elderly waiver and personal care assistants. How-to Videos. (function() { For more information contact the plan. . Providers may access remittances and notifications free of charge through our secured provider portal. (313) 664-8800(Monday through Friday from 8 a.m. to 5 p.m.) Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. What would you like to do? var gcse = document.createElement('script'); Information on the Children's Protective Services Program, child abuse reporting procedures, and help for parents in caring for their children. Power Member Satisfaction Study, Partnership with Home Access Health for In Home Screenings, Urgent Care Centers: Reimbursement for COVID 19 Vaccine Administration, Health Risk Assessment for Healthy Michigan Plan Members, Appointment Availability for HAP Empowered MI Health Link Members, Prior Authorization Temporary Waiver Reinstate for Skilled Nursing Facility Admissions, HAP Extends Cost-Share Waivers for Testing, Treatment and Telehealth Services Related to COVID-19 through Sept. 30, 2021, Billing Guidelines for COVID-19 related Services and Vaccine Administration, Helping HAP Empowered Medicaid Members Stay Healthy, Infection Control Training Videos Available from MDHHS, New Partnership for Non-Emergency Medical Transportation, Part D Drug Appeals - Independent Review Entity Change, HAP Empowered Duals (HMO SNP) Annual Required Training, Update: HAP extends cost-share waivers during public health emergency for testing and telehealth services through April 21, 2021, New program for your HAP Empowered MI Health Link patients, Update: Skilled Nursing Facility Admissions - Prior Authorization Temporarily Waived Extended, Telemedicine, Telehealth & Virtual Care Services Updated, HAP Empowered Provider Newsletter - December 2020, Updated immunizations and vaccine policy to include COVID-19 vaccine codes, Billing Guidelines for COVID-19 - Update December 17, 2020, Reminder - New Partnership with EyeMed to Manage Routine Vision Benefits, Notification of Pregnancy Form Low Birth Weight Initiative, Important Announcement from MDHHS Regarding New COVID-19 Provider Vaccination Registration Form, HAP extending cost-share waivers for testing & treatment of COVID-19 for services rendered through March 31, 2021, Skilled Nursing Facility Admissions Prior Auth Update, Reimbursement for COVID-19 Testing at Urgent Care Centers, HAP extends cost-share waivers for testing & treatment of COVID-19 through Jan 21 2021, HAP Empowered Claims Submissions Guidelines, Ordering Referring and Attending Providers Requirements for HAP Empowered Claims, Telehealth Summary (overview of HEDIS measures that can be addressed via telehealth), Well Child Visits Guidance for In Person and Telemedicine Visits, MDHHS Reinstates Certain Provider Enrollment Requirements, Ensure Your Claims Get Paid - CHAMPS Enrollment Reminder, Care Management Codes Denied in Error for HAP Empowered Medicaid Claims, Potential Overpayment for Home Health Claims for HAP Empowered MI Health Link, Medicaid Prescription Drug Therapy Coming October 1, 2020. SR-AHEC Training: An Overview of Suicide Risk Assessment and Management. Outpatient & preservice elective inpatient services The Provider's Remittance Advice provides a detailed explanation of claim payments, denials to provider and/or member, code editing explanations (included on your ERA) and adjustments for each detail charge submitted. Authorizing Electronic Funds Transfer (or EFT) as your payment method will speed payment delivery by depositing payments directly to your bank account, allowing quicker access to funds paid to you. endstream endobj 202 0 obj <>/Metadata 15 0 R/PageLayout/OneColumn/Pages 199 0 R/StructTreeRoot 48 0 R/Type/Catalog>> endobj 203 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 204 0 obj <>stream We support a culture of knowledge and creativity with competitive pay packages, a robust benefits package and a . However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Still Time to Qualify for Reimbursement for Gap Closure! To see all of these plans, go to the Health Insurance Marketplace at HealthCare.gov. Inpatient admissions & observations Information about audits conducted by the Office of Audit. The Alliance billing and enrollment team will offer virtual information and technical assistance sessions for claims and enrollment related topics and questions. Looking for your plan home page or interested in becoming a Provider? Information on the Children's Foster Care program and becoming a Foster Parent. View their Remittance Advices. s.parentNode.insertBefore(gcse, s); Molina Healthcare, Inc. Investor Relations: Juan Jos Orellana, 562-435-3666 or Public Relations: Leigh Woodward, 562-233-4532 or HAP Midwest Health Plan, Inc. Susan Schwandt, 248-443 . Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. and Lodge), Flint Lobby Customer Service 0 The Alliance Health/Okta Provider Portal has been successfully deployed and your user account and access has been migrated to the new Provider Portal platform. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. Contact Provider EDI Support Already have an account? 24/7 access to eligibility, benefits, authorizations and more. Benefits may vary by carrier and location. 2050 S. Linden Rd. Be Cyber-smart! Questions and Answers (Q&A) - View answers to important and frequently asked questions. 2850 W. Grand Blvd. All contents copyright Health Alliance Medical Plans. We are an independent education, research, and technology company. Alliance Health is excited to implement this new Provider Portal and with the ability to provide our users with a single user login and password that allows the user to access to multiple applications and other valuable information from a single dashboard. Adult Behavioral Health & Developmental Disability Services. Certain waived policies that were in place during the PHE are now in the process of unwinding and will continue the unwind process as the authority for these policies expire. Report a compliance concern or potential fraud, waste or abuse. Use the search function below to search Provider Central, These updates support providers by highlighting new classes, trainings, resources, chats, procedures, and programs. Welcome to Harvard Pilgrim's Provider Portal! We recommend you download Adobe Reader to view all PDF files on this page. /_,2W(J@MYZQDtP)xRrv f:}bTW=ta-.:JL0kCKz%_2QHNMF`j?eV|'vu`+#.Y: HealthPartners strongly encourages EFT as your payment method so you have your access to your payments as soon as . Bus ireann's family portal closes on April 28th for transport services for the 2023/2024 school year. (888) 658-2536 TTY: 711 Information on the Food Assistance Program, eligibility requirements, and other food resources. #current year# Health Alliance Plan of Michigan. Look Up Providers. Information on communicable & chronic diseases. WebMeridian Health Plan 888-773-2647 Southwest Michigan HAP Midwest Health Plan 313-827-5734 Macomb . The Medicare plans represented are PDP, HMO, PPO or PFFS plans with a Medicare contract. Once you have completed the activation process, please navigate to the Alliance Health Provider Portal, where you will be prompted to log into the new Provider Portal. (800) 888-9885 (TTY: 711) MondayFriday, 8 am to 8 pm. This portal has replaced your current sign-in procedures for ACS and other Alliance applications. MQIC is led by physicians and other clinical team members who evaluate scientific data and develop guidelines to help support the work of primary care physicians. If you're a doctor bringing patients care or you work in a doctor's office, sign up for Your Health Alliance. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Referrals and prior authorization for services should be made to in-network providers whenever possible. Meridian To help patients engage their health care provider in these conversations and empower them to ask questions about what tests and procedures are right for them, Helpful materials on healthcare for Children from the American Academy of Pediatrics, the largest physician organization dedicated to the health of children. 2023 Medicare Advantage Plan Benefit Details for the HAP Midwest MI Health Link (Medicare-Medicaid Plan) - H9712-001-. Care Guidelines help caregivers provide the right care at the right time using the most current evidence to result in the best outcomes. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Quick and easy access to. The application will also allow Alliance to implement additional security features in the future, such as multi-factor authentication. 618 Kenmoor Ave SE, Suite 200 If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. Rochester Endocrinlogy/Diabetes Center is a medical group practice located in Rochester Hills, MI that specializes in Endocrinology, Diabetes & Metabolism. Drug plan deductible: No annual deductible, Non-Medicare covered Prosthetics/Medical Supplies: Covered. Self-funded / ASO. Toll free: (800) 422-4641, Provider Inquiries: Update your Cigna provider directory . With that in mind, we want to make it easy for you to do business with us. Contacts. For additional information about this plan(s), please contact HAP Empowered MI Health Link. Providers who do not contract with the plan are not required to see you except in an emergency. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). Representatives are available Monday - Friday 7 a.m. - 9 p.m. Central Time. Clinical Tools, Resources, and Guidelines, Tobacco Free Toolkit for Behavioral Health Agencies, Co-Occurring MH-SUD Diagnoses Screening Program, Healthcare Effectiveness Data and Information Set (HEDIS), Quality Management and Incident Reporting, Licensed Independent Practitioners Compliance Requirements, Claims and Enrollment Guide Fiscal Year 2023 2024. Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). L&0$L`R%Ykl0ZPy% 4H`bp`cI~&LI Below are several of the organizations that our clinical teams review in order to promote the most updated clinical practice guidelines to promote healthy outcomes for HAP members: -Choosing Wisely:https://www.choosingwisely.org/patient-resources/, -Patient Care Materials from American Academy of Pediatrics:https://www.aap.org/en/patient-care/, -Clinical Guidelines and Recommendations:https://www.acponline.org/clinical-information/guidelines, -Clinical Practice Guidelines:https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline, -Clinical Practice Guidelines:https://www.aafp.org/family-physician/patient-care/clinical-recommendations.html. select Procedure Reference Lists under Quick Links. Any information we provide is limited to those plans we do offer in your area. Please clear your browser cache BEFORE accessing the new Provider Portal URL. Matrix Medical Network Partnership for Free In-Home Health Visits, Primary Care Physician Offices We Need Your Help, Keep Provider Information Updated in NPPES, Updated - Prior Authorization Requirements Removed for Specific Drugs for Your HAP Empowered Medicaid Patients, Prior Authorization Requirements Removed for Specific Drugs for Your HAP Empowered Patients, New Coding Validation Process Coming Soon, Attention Physician Specialists: Your Patients Could Benefit from a Free Maternity Care Management Program, Healthy Michigan Plan Health Risk Assessment Resources, Connecting MI Health Link Beneficiaries with Veterans Services, Claim Editing Guidelines for Attending Ordering Referring Provider Fields, Formula Shortage - Information from MDHHS, Formula Shortage Do's and Don'ts - Information from MDHHS, Reminder Telemedicine Services Billing for HAP Empowered Medicaid, COVID-19: Coverage of Monoclonal Antibody Injections by Pharmacy Providers, Reminder - Medical Record Review Projects, Notification from The Michigan Health Alert Network: Rapid Rise in Congenital Syphilis, Update - Urgent Care Centers Reimbursement for COVID 19 Vaccine Administration, Billing Guidelines for COVID-19 Vaccine Administration Only, Patient Case Study from the Maternity Care Management Program, Process for Submitting Claims Corrections, Institute for Health Policy Annual Spring Case Management Conference, Submitting HCPCS Codes with an NDC on HAP Empowered Claims, Reminder HAP Empowered Duals HMO DNSP Required Training, Updated Notice from the Michigan Department of Health & Human Services: Prescription Drug Monitoring Program Requirements for Providers, Requesting Access or Deleting Access to NPIs and Tax IDs Online, Pregnancy Resources to Help You Care for Your HAP Empowered Patients, MDHHS and the NYC STD Prevention Training Center March 2022 Urgent Update Webinar, Encourage Your MI Health Link Patients to Update their Contact Information, Prior Authorization Temporary Waiver Ends Soon for Skilled Nursing Facility Admissions, Important Information for OB/GYNs: Maternity Care Management Program Update, Encourage Your Medicaid Patients to Update their Contact Information, Prescribing Outpatient Treatments for COVID-19, Update - Urgent Care Centers Reimbursement for COVID 19 Vaccine Administration - January 2022, Prescribing Oral Antivirals Paxlovid and Molnupiravir for COVID-19, Skilled Nursing Facility Admissions - Prior Authorization Temporary Waiver Extended, Updated Respiratory Viral Panel Testing Policy - January 2022, Updated Billing Guidelines for Outpatient Services For COVID-19 Cost Share Waiver and Telehealth Services - January 2022, Updated Billing Guidelines for COVID-19 Vaccine Administration Only - January 2022, FQHCs, RHCs and THCs May Need to Resubmit Telehealth Services Claims, Reminder - HAP Progeny Maternity Services Program and FAQS, Skilled Nursing Facilities COVID 19 Reimbursement per the Michigan Department of Health and Human Services, Updated Policy for Coverage of Vascular Endothelial Growth Factor Inhibitors (VEGF) for Ocular Indications, MDHHS Creates Blood Pressure Cuff Coverage Grid, COVID-19 Testing Coverage for Medicaid Members - Bulletin from the MDHHS, Healthy Michigan Plan Health Risk Assessment Video Resources, Primary Care Physicians - Accessibility and Availability Requirements, Michigan Family Connections Newsletter - Fall 2021, Provider Information Sheet Sickle Cell Disease Expansion, Skilled Nursing Facility Admissions - Prior Authorization Temporary Waiver Reinstated, Update: Urgent Care Centers Reimbursement for COVID 19 Vaccine Administration, NDC Reporting Requirement for Physician Administered Drugs, Flu Vaccine Resources from the Centers for Medicare & Medicaid Services. View member eligibility. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. (800) 422-4641 Provider Information Change Form (for contracted providers), Health Alliance Credentialing Application (for contracted midlevel providers), CAQH Provider Addition Form (for IL contracted MDs and DOs only), Prior Authorization & Clinical Review Criteria, Illinois Uniform Electronic Prior Authorization, Provider Reference Checklist - Acute Inpatient/Mental Health/Substance Abuse, Provider Reference Checklist - Outpatient, Provider Reference Checklist - Post Acute, Provider Reference Checklist - Transplant (Admissions), Provider Reference Checklist - Transplant Center, Ancillary/Facility Credentialing Checklist, Pharmacy Prior Authorization Provider Portal Guide, Link to Health Alliance Provider Training Recording, Altruisa/Guiding Care Prior Authorization Video, Morphine Equivalent Dose (MED)/Opioid Medication Supplemental Information Form - (fill), Health Alliance Northwest Emergency Fill List Included Drugs, Health Alliance Northwest Emergency Fill List Excluded Drugs, 2022 Medicare State of Illinois Formulary, 2023 Health Alliance Individual and Small Group Formulary, 2023 Health Alliance Northwest Individual & Small Group Formulary, 2023 Health Alliance State of Illinois Employee Formulary, 2023 Health Alliance Northwest Large Group Formulary, 2023 Large Group and Self-Funded Standard Formulary, 2023 Large Group and Self-Funded Enhanced Formulary, Statin Therapy for Patients with Cardiovascular Disease, Statin Use in Persons with Diabetes Tip Sheet, Transitions of Care-Patient Engagement After Inpatient Discharge, Transitions of Care-Receipt of Discharge Information, Transitions of Care-Notification of Inpatient Admission, Transitions of Care-Medication Reconciliation Post Discharge, Percentage of Inpatient Admissions with Follow Up Withing 14 Calendar Days, Kidney Health Evaluation for Patients with Diabetes KED, Provider Reference Checklist Acute Inpatient/Mental Health/Substance Abuse, Provider Reference Checklist Outpatient, Provider Reference Checklist Post Acute, Provider Reference Checklist Transplant (Admissions), Provider Reference Checklist Transplant Center, Morphine Equivalent Dose (MED)/Opioid Medication Supplemental Information Form (fill). Those who disenroll It provides links to CHAMPS, billing and reimbursement resources, training, policy documents, and much more. Low-income Households Water Assistance Program (LIHWAP). Limitations, copayments, and restrictions may apply. Beyond completed suicides, suicidal behavior is common therefore a thorough understanding of how to assess for risk as Changes Made to ACS Service Definition Drop Downs for Service Authorization Requests. This results in more reliable communication and notification. Referrals and prior authorizations must be obtained prior to services being rendered. You have 24 hour access to provider . Heritage Vision Plans provides affordable, high-quality vision benefits for companies of all sizes. Medicare evaluates plans based on a 5-Star rating system. Thank you for being a provider with HAP Empowered Health Plan, Inc. We appreciate the care that you give to HAP memberswith Medicaid and MI Health Link coverage. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Check claims, payments, and fee schedules. Timely Payment Guidelines Alliance Provider Support is available to answer provider questions about authorization, billing, claims, enrollment, ACS, or other issues. Commercial Protect your access to the HealthPartners Provider Portal by reviewing our Password Practices & Tip Sheet. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. 711, Health Alliance Plan Forgot Your Password for the Provider Portal? 952-883-7505 You will then have access to all of your assigned applications. Updated Information for Medicaid Members - Expanded Coverage and Reimbursement for Virtual Visits and Telehealth, Expanded Coverage and Reimbursement for Virtual Visits and Telehealth, Telemedicine Visits for Your HAP Empowered Patients, Potential Overpayment for HAP Empowered Claims, Michigan Department of Health and Human Services Newborn Recoveries, New Process for Submitting Additional Clinical Information for Acute Inpatient Admissions, DME and Prosthetic and Orthotic Providers Ensure Your Claims Get Paid, Revised: Taxonomy Codes Required on Professional Claims, HAP Empowered Claim Adjustments How to Ensure Payment, Trusted HP Michigan Integration with HAP Empowered, Ensure claims for your HAP Empowered patients get paid, Taxonomy codes required on professional claims, Register now for Healthy Michigan Plan Forum, Trusted acquisition letter to Trusted providers, HAP acquisition of Trusted HP press release, Closing gaps in care for HAP Empowered MI Health Link members, Medicaid provider enrollment in CHAMPS requirement for prescribers, HAP Empowered Provider Communication Claims Submission ID, Capitation Payments and Reports for Your HAP Empowered Patients, Billing for Urgent Care Services for HAP Empowered Members, Provider Portal Online Applications and Helpful Information, Fact sheet: Submit health risk assessment via CHAMPS, 2019 HAP Midwest Health Plan Access to Care Availability Standards FINAL, Exciting Changes Coming to HAP Midwest this June, Change in Submitting Authorizations for HAP Midwest Members, Therapy Limits for Medicare Members June 2018, Requirement for Providers to Enroll in CHAMPS, HAP Empowered Childrens Special Health Care Services program. hWOHW#T!%R E|0RJNg;Q3 CEUs Offered! '//cse.google.com/cse.js?cx=' + cx; Allied partners with several high-performing provider networks, so you can customize your care options to align with your needs. Information is collected to monitor the general health and well-being of Michigan citizens. #current year# Health Alliance Plan of Michigan. providers must be paid within 30 calendar days of the date of receipt. 1414 E. Maple This new model of care was developed to address the overall health care needs of Medicaid beneficiaries who have complex behavioral health or intellectual and developmental disability (IDD) service needs. Our. 226 0 obj <>/Filter/FlateDecode/ID[<894DCE6A2D3BB64E98F59EB5EFA2D304><7180BDC57D7BC34B92496B641500D662>]/Index[201 46]/Info 200 0 R/Length 114/Prev 142278/Root 202 0 R/Size 247/Type/XRef/W[1 3 1]>>stream To start an appeal: Call us at (800) 500-3373, fax us at (217) 902-9708, or mail us your appeal in writing to: ATTN: Member and Provider Resolutions In case of any discrepancy between this information and the legal source, the legal source will govern in all cases. HAP adopts and supports clinical practice or care guidelines for the treatment of a variety of medical and behavioral conditions. HAP Midwest currently offers Medicaid products only in Region 6, which includes Genesee, Huron, Lapeer, Shiawassee, St. Clair and Tuscola counties in mid-Michigan and the Thumb, where it covers . gcse.src = (document.location.protocol == 'https:' ? Until then people will keep getting services the way they do now. MQIC review the guidelines every two years or as needed. Please ACTIVATE your account as soon as possible. Contact your clearing house and give them HAP's payor ID: 38224. No Surprises Act information for non-contracted providers Members may enroll in a Medicare Advantage plan only during specific times of the year. Midwest Radio is the Number 1 local radio in Ireland . %%EOF Apply for Benefits. J>hm&$TN:0PbSy?7xx&:DA'Ix"LeB]8@bv (800) 801-1770 TTY: 711 We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. Aud;'tadr2k''wjf6e>R Y)^41Ml. Call Provider Services at 888-773-2647 (TTY 711) with any questions. Monday through Friday, from 9:00 a.m. to 4:30 p.m. Pharmacy requests For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), Post discharge In-Home Medication Reconciliation: Wigs for Hair Loss Related to Chemotherapy: Additional Sessions of Smoking and Tobacco Cessation Counseling: Enhanced Disease Management: Some coverage, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline): Some coverage. Please contact Medicare.gov or 1-800- MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Plan ID: H9712 - 001 - 0 One of HAPs greatest strengths is our large and diverse provider network. Notice from the Michigan Department of Health & Human Services: Prescription Drug Monitoring Program Requirements for Providers, Diagnosis Requirement for ESRD Facilities, CDC Health Advisory - Recall of LeadCare Blood Lead Tests, HAP ranks highest in Michigan in J.D. Be sure to sign and date the W-9 form or it will be returned. While HAP Midwest is no longer available in your area, Molina Healthcare of Michigan will continue providing the same high quality customer care to their Medicaid, MIChild, Healthy Michigan Plan or Children .

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