11/19/2025
Health Alliance Plan
Health Alliance Plan Managed Care Committee Member
April Danish, CHONC - Newland Medical Associates
Changes Effective January 1, 2026
Process Change When Providers Appeal On Behalf of a Member
You might appeal a decision on behalf of your HAP Commercial patient, which could include attending a hearing to present the rationale on why we should overturn a denied decision.
Effective January 1, 2026, hearings for second-level appeals for HAP Commercial members will no longer be offered as part of our appeals process. This change will not affect your right to submit a second-level appeal, nor will it change the criteria or timelines for filing.
We will continue to send letters to members and providers when a provider is appealing on behalf of a member. The letter contains appropriate instructions on our process.
HAP CareSource™ MI Coordinated Health (HMO D-SNP)
The Michigan Department of Health and Human Services (MDHHS) has selected HAP CareSource to offer a combined Medicare and Medicaid plan, HAP CareSource™ MI Coordinated Health (HMO D-SNP), in Macomb and Wayne counties, effective January 1, 2026. READ MORE
Formulary and Prior Authorization Changes in 2026 HERE
New Plans and Plan Changes in 2026 HERE
Additional Information
Provider Call Center Experiencing Longer Than Normal Wait Times
The HAP Provider Inquiry department is currently experiencing longer than normal wait times to speak to a representative.
For faster service, please use our secure provider portal. Simply log in at hap.org to:
• Verify benefits and eligibility
• Review claim status
• Verify if a procedure requires an authorization
• Review and print a remittance advice
• Request reconsideration for denied claims
• And much more
You can also verify benefits and eligibility and status claims by phone. Just call (866) 766-4661 and follow the prompts.
We apologize for the inconvenience!