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Self-funded / ASO. 'https:' : 'http:') + We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. No Surprises Act information for non-contracted providers Tailored Plan Provider Training Registration, Tailored Plan Provider Contract Templates, Opioid Misuse Prevention and Treatment Program. ?#^b7[]OF{u.=tOi+~xIL7:Tur>kW:]y+x1+\XYW+-yC~e~E~cNK%r\ {f,2m6oL KB#. asm 126 4 of 8 mi health link program asb 2022-002 2-1-2022 adult services manual state of michigan department of health & human services hap midwest health plan 2850 w. grand blvd. HAPs medical director team continually evaluates the clinical guidelines established by the nations most prominent primary care and value-based associations to promote guidelines that support the overall physical and mental health of our members. If you're an EyeMed member looking for vision benefit services, please call your provider to confirm their specific response whether amending store hours or closing. WebThank you for being a provider with HAP Empowered Health Plan, Inc. We appreciate the care that you give to HAP members with Medicaid and MI Health Link coverage. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. (888) 658-2536 TTY: 711 Birth, Death, Marriage and Divorce Records. Bridge Card Participation Information on Electronic Benefits for clients and businesses, lists of participating retailers and ATMs, and QUEST. This change was made to align with clinical coverage policies. One of HAPs greatest strengths is our large and diverse provider network. Referrals and prior authorization for services should be made to in-network providers whenever possible. For additional information, please see the Alliance Health Portal Provider User Guide. 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. hbbd```b``} LN e>0 /Hx0 A0{dT\Q 2QH2m&`5`6G = 68PN&w m You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. 201 0 obj <> endobj ACS allows providers to view appointments, submit patient claims and treatment plans, check on authorizations, and more. You must continue to pay your Part B premium. HAP Empowereddoes not require referrals to see an in-network specialist. Information on treatment and services for juvenile offenders, success stories, and more. Flint, MI 48532 In certain situations, you can. Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Register to Vote. For more information on your Medicare coverage, please be sure . All rights reserved. The information, tools, and resources you need to support the day-to-day needs of your office are all on the Cigna for Health Care Providers' website, CignaforHCP.com : Check patient eligibility and benefits. HAP Senior Plus(PPO) Representatives are available Monday - Friday 7 a.m. - 9 p.m. Central Time. HAP Senior Plus Heritage Vision Plans provides affordable, high-quality vision benefits for companies of all sizes. eviCore: cardiac imaging, musculoskeletal, radiology services & sleep studies 835 Electronic Remittance Advice: scroll down to learn more about our contracted clearinghouses. 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. Detroit, MI 48202, Monday through Friday, from 9:00 a.m. to 4:30 p.m. var s = document.getElementsByTagName('script')[0]; (313) 664-8833, #3 (Monday through Friday from 8 a.m. to 5 p.m.) Be Cyber-smart! View member eligibility. Log In Now. Helping Developers create Next Generation Digital Experiences using Secure Innovative APIs Medicare MSA Plans do not cover prescription drugs. The benefit information provided is a brief summary, not a complete description of benefits. 24/7 access to eligibility, benefits, authorizations and more. 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). 2850 W. Grand Blvd. Looking for your plan home page or interested in becoming a Provider? 2023 HAP Midwest MI Health Link (Medicare-Medicaid Plan) Health (9 days ago) Web2023 Medicare Advantage Plan Details. L&0$L`R%Ykl0ZPy% 4H`bp`cI~&LI Join our Network - Recruiting Physical Health Care Providers; Provider Portal Login; TP Provider Manual - Effective 12/1 . 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. Tailored Plan - Effective October 1, 2023. Monthly Drug Premium *Included in Monthly Plan Premium. 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 . Please clear your browser cache BEFORE accessing the new Provider Portal URL. Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. We are an independent education, research, and technology company. Inquire on a patient's eligibility. How-to Videos. (800) 422-4641 hWOHW#T!%R E|0RJNg;Q3 EyeMed remains committed to the continuity of service for your vision business as we all respond to the COVID-19 global health pandemic. Please clear your browser cache before accessing the new Provider Portal URL. Empower Healthcare Solutions, LLC (Empower) is a Provider-led Arkansas Shared Savings Entity (PASSE). Contact your assigned network development specialist. It provides links to CHAMPS, billing and reimbursement resources, training, policy documents, and much more. 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. Or get everything you need to manage your relationship with HAP online. Do they have the capability to post remittances electronically. The application will also allow Alliance to implement additional security features in the future, such as multi-factor authentication. Tell Your Story #MySoonerCare. Alliance Medicare Supplement: Commercial For a complete list of services that require authorization,log inandselect Procedure Reference Lists under Quick Links. 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. The activation email expires thirty days from the date issued. HAP Senior Plus(PPO) Recruiting Physical Health Care Providers. Aud;'tadr2k''wjf6e>R Y)^41Ml. A sample remittance advice is included at the end of this section. One of HAP's greatest strengths is our large and diverse provider network. Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Be sure to sign and date the W-9 form or it will be returned. This portal has replaced your current sign-in procedures for ACS and other Alliance applications. With that in mind, we want to make it easy for you to do business with us. Contact your Provider Services Administrators by network: Commercial (W. Grand Blvd. All Rights Reserved. Providers Home. Information about injury and violence prevention programs in Michigan. MQICs goal is to standardize these practice guidelines to help all physicians in Southeast Michigan; and HAP is helping these efforts. >EZ/86 K~L(h\UqMHdG'=S1p$>Z_Q/P? Child Welfare Medical and Behavioral Health Resources. You now have an easier, faster, and more secure way to log in to the Alliance Claims System and to other provider applications that are supported by Alliance Health. Medicare has neither reviewed nor endorsed the information on our site. Pharmacy Programs Health Alliance. Monday through Friday, from 8 a.m. to 7 p.m. Detroit area: (313) 872-8100 . Access our provider portal to begin your request. View their Remittance Advices. Bus ireann's family portal closes on April 28th for transport services for the 2023/2024 school year. CEUs Offered! When you log in to the Alliance Provider Portals beginning the morning of May 20, 2022, you will be directed to the Alliance Health/Okta platform, where you will be prompted to complete your enrollment, including resetting your password. Contact the plan provider for additional information. (866) 766-4661 (self-service available 24/7), Via Telecommunications Device for the Deaf (TDD): 835 Electronic Remittance Advice: scroll down to learn more about our contracted clearinghouses. Report a compliance concern or potential fraud, waste or abuse. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. #current year# Health Alliance Plan of Michigan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. You will also find advice and guidance for providers. Learn about our responses to Coronavirus and find the latest program guidance. Disclaimer and Privacy Policy | Terms of Use 2013 BeneSys Administrators All content on this site is copyrighted by BeneSys Administrators. Wednesday 04/26/2023 10:27 PM. Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. Some services and procedures require prior authorization. For a complete list of services that require authorization. To learn more about the step in the prior authorization process, see the Referrals and Authorizations section in the Provider Manual. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. 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 NC Medicaid has changed the start date for Tailored Plans to October 1, 2023. $/o|PXPXP,g3xE^-xGyYzza^X/:=2,,,,!o/03 For additional information about this plan(s), please contact HAP Empowered MI Health Link. These guidelines are used in combination with your clinical judgement and knowledge as a physician. Alliance Health and Life Insurance Company. (800) 873-7526 TTY: 711. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. Monday through Friday, from 9:00 a.m. to 4:30 p.m. Registration help. These sessions are formatted for provider agency staff directly involved in the submission of enrollments and claims and will include All provider information and resources have been consolidated into a new section of the website called Provider Central. A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival. If you're a doctor bringing patients care or you work in a doctor's office, sign up for Your Health Alliance. Call Provider Services at 888-773-2647 (TTY 711) with any questions. HAP Senior Plus (888) 658-2536 TTY: 711 Call HAP Provider Inquiry at (866) 766-4661. Plan ID: H9712 - 001 - 0 Update your Cigna provider directory . hb```f`` zAX,6$400X>$LMCrc~e:*::;:;@dEG\'PsKb )LE"oxrVie9 )ar%at.530Ae`pL@u\ ]- As per federal legislation, Michigan will restart monthly eligibility renewals for both fee-for-service Medicaid and Medicaid Health Plan (MHP)starting in June 2023. Are there additional per remittance charges associated with this capability? HAP is a key participant in the Michigan Quality Improvement Consortium (MQIC) an organization of health plans focused on the health of our members in Michigan. Our migrant program works with a number of organizations to provide services for Michigans migrant and seasonal farmworkers. Contact Provider EDI Support Please ACTIVATE your account as soon as possible. Apply for Benefits. Molina Healthcare of Michigan is one of the largest health plans in Michigan. HealthPartners is able to send an Electronic Remittance Advice (ERA) in a HIPAA compliant version (Claim Payment/Advice: 835V005010X221A1) to your facility through the following intermediaries/clearinghouses: Interface and installation fees for claim submission and remittance advice are dependent upon the facility, annual claim volume and other determining factors. (800) 873-7526 TTY: 711. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Not affiliated with or endorsed by any government agency. Allied team members are problem-solvers, innovators and collaborators. Box 02459 Detroit, MI 48202-2459. This page provides information for healthcare providers who provide services to Medicaid beneficiaries or would like to enroll as a Medicaid provider. Information on the Safe Delivery Program, laws, and publications. If you need additional assistance with the enrollment process, please contact the Alliance Helpdesk at [emailprotected]. In case of any discrepancy between this information and the legal source, the legal source will govern in all cases. Please contact the plan for further details. 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. var gcse = document.createElement('script'); The Provider Portal application will be unavailable on Saturday, May 6th 12:00 PM CST - 12:00 AM CST for special maintenance activities. The Provider Manualwill guide you through the important administrative items you need to know to manage your partnership with HAP Empowered such as: This manual is reviewed annually and updated throughout the year as necessary. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. money from Medicare into the account. Medicaid Rates for FY23April and May 2023, Provider Request for Appeal of an Action Form. J>hm&$TN:0PbSy?7xx&:DA'Ix"LeB]8@bv Our network includes award-winning and patient-focused doctors, hospitals and health systems in Michigan. 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. HAPs clinical and medical policy team continue to evaluate scientific data, published evidence, and directives from trustworthy health care organizations to promote and establish clinical guidelines. Adult & Children's Services collapsed link, Safety & Injury Prevention collapsed link, Emergency Relief: Home, Utilities & Burial, Adult Behavioral Health & Developmental Disability, https://dev.michigan.local/som/json?sc_device=json, Behavioral and Physical Health and Aging Services Administration, Immunization Info for Families & Providers, Michigan Maternal Mortality Surveillance Program, Informed Consent for Abortion for Patients, Informed Consent for Abortion for Providers, Go to Child Welfare Medical and Behavioral Health Resources, Go to Children's Special Health Care Services, General Information For Families About CSHCS, Go to Emergency Relief: Home, Utilities & Burial, Supplemental Nutrition Assistance Program Education, Go to Low-income Households Water Assistance Program (LIHWAP), Go to Children's & Adult Protective Services, Go to Children's Trust Fund - Abuse Prevention, Bureau of Emergency Preparedness, EMS, and Systems of Care, Division of Emergency Preparedness & Response, Infant Safe Sleep for EMS Agencies and Fire Departments, Go to Adult Behavioral Health & Developmental Disability, Behavioral Health Information Sharing & Privacy, Integrated Treatment for Co-occurring Disorders, Cardiovascular Health, Nutrition & Physical Activity, Office of Equity and Minority Health (OEMH), Communicable Disease Information and Resources, Mother Infant Health & Equity Improvement Plan (MIHEIP), Michigan Perinatal Quality Collaborative (MI PQC), Mother Infant Health & Equity Collaborative (MIHEC) Meetings, Go to Birth, Death, Marriage and Divorce Records, Child Lead Exposure Elimination Commission, Coronavirus Task Force on Racial Disparities, Michigan Commission on Services to the Aging, Nursing Home Workforce Stabilization Council, Guy Thompson Parent Advisory Council (GTPAC), Strengthening Our Focus on Children & Families, Supports for Working with Youth Who Identify as LGBTQ, Go to Contractor and Subrecipient Resources, Civil Monetary Penalty (CMP) Grant Program, Nurse Aide Training and Testing Reimbursement Forms and Instructions, MI Kids Now Student Loan Repayment Program, Michigan Opioid Treatment Access Loan Repayment Program, MI Interagency Migrant Services Committee, Go to Protect MiFamily -Title IV-E Waiver, Students in Energy Efficiency-Related Field, Go to Community & Volunteer Opportunities, Go to Reports & Statistics - Health Services, Other Chronic Disease & Injury Control Data, Nondiscrimination Statement (No discriminacion), 2022-2024 Social Determinants of Health Strategy, Go to Reports & Statistics - Human Services, Improving Care for Justice Involved Patients, Managed Long Term Services and Supports (MLTSS), Michigan Office of Administrative Hearing and Rules for MDHHS, Health Care Coverage for People Impacted by Flint Water, Primary Care Provider Incentive Payment Program, Program of All-Inclusive Care for the Elderly (PACE). We are not compensated for Medicare plan enrollments. gcse.type = 'text/javascript'; However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. HAP Empowered Duals (HMO SNP) - Are you Participating? And it continues to grow. Use the search function below to search Provider Central, These updates support providers by highlighting new classes, trainings, resources, chats, procedures, and programs. Submenu for Insurance through your employer, Learn more about individual and family plans, To refer a member to an out-of-network provider, please contact our. 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.

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