Become a provider

Download our credentialing policy (PDF) to learn about:

• HAP's credentialing standards requirements and procedures
• Your right to review information obtained from outside sources to support your application
• Your right to correct erroneous information
• Your right to be informed of your application status throughout the credentialing process

To provide hearing aid services for HAP and HAP CareSource members, you must participate with the NationsHearing provider network. If you aren’t participating and would like to join, contact NationsHearing by:

• Phone: (800) 921-4559
• Email:network@nationshearing.com

For the following ancillary groups:

• Ambulance
• Ambulatory Surgery Center
• Anesthesia Groups
• CRNA Groups
• DME
• Dialysis
• Diagnostic Imaging and Radiology
• Federally Qualified Health Center (FQHC)
• Home Health Care
• Home Infusion and Outpatient Infusion
• Hospice
• Lab (proprietary testing only)
• Local Health Departments
• Long Term Acute Care
• Pathology Groups
• PT/OT/ST - Note: Roster required with submission
• Prosthetics & Orthotics
• Skilled Nursing Facility
• Sleep Disorder Center
• Urgent Care

Please complete the following:

1. Ancillary Group Provider Application.
2. HAP Disclosure of Ownership and Control Interest form.
3. Email completed application and required documents to providernetwork@hap.org. Put “ancillary application” in the subject line.

For the following behavioral health providers:

• Autism Centers
• Community Mental Health Centers
• Inpatient Addiction Disorder Facilities
• Inpatient Mental Health Facilities
• Inpatient Psychiatric Hospital
• Outpatient Addiction Disorder Facilities
• Outpatient Ambulatory Facilities
• Outpatient Mental Health Facilities
• Partial Day Hospitals

Please complete the following:

1. Coordinated Behavioral Health Management Facility Center Credentialing Application
2. HAP Disclosure of Ownership and Control Interest form.
3. Email completed application and required documents to providernetwork@hap.org. Put “behavioral health application” in the subject line.

For the following individual behavioral health providers:

• Board Certified Behavior Analysts (BCBA)
• Fully Licensed Psychologists (PhD/PsyD)
• Licensed Professional Counselors (LPC)
• Master Level Psychologists (LLP)
• Master Level Social Workers (LMSW)

Please complete the following:

1. Provider Enrollment Form
2. HAP Disclosure of Ownership and Control Interest Form
3. Children’s Special Healthcare Services Provider Attestation (if applicable)

Email completed application and required documents to providernetwork@hap.org. Put “behavioral health application” in the subject line.

To provide services to HAP CareSource Medicaid members, you must be part of the HAP CareSource Medicaid network. You must also be a certified provider and active in CHAMPS. Once you are active per MDHHS guidelines, you can enroll with us by completing and submitting the forms below.

• Community Health Workers Form
• Doula Form
• Michigan Diabetes Prevention Program Provider Form
• MIHP Form
• Care Coordination Agreement (CCA) Form – MIHP providers only
• HAP Disclosure of Ownership and Control Interest Statement Form

For more information on:

• Community Health Workers, requirements and guidelines visit here.
• Doula requirements and guidelines, visit here.
• Michigan Diabetes Prevention Program, requirements and guidelines visit here.
• MIHP, requirements and guidelines visit here.

For the following physicians and physician groups:

• Allopaths (MD)
• Osteopaths (DO)
• Nurse Practitioners (NP)
• Physician Assistants (PA)
• Certified Nurse Midwives (CNM)
• Chiropractors (DC)
• Dentists (DDS) (only oral and maxillofacial surgeons providing care under medical benefits)
• Optometrists (OD)
• Pain Management Specialists
• Podiatrists (DPM)
• Licensed Genetic Counselors (LGC)
• Board Certified Behavior Analysts (BCBA)
• Fully Licensed Psychologists (PhD/PsyD)
• Licensed Professional Counselors (LPC)
• Master Level Psychologists (LLP)
• Master Level Social Workers (LMSW)

(Acupuncturists are credentialed as an exception based on the health plan's need)

Please complete the following:

1. Provider Enrollment Form
2. HAP Disclosure of Ownership and Control Interest form
3. Collaborative Physician Agreement (nurse practitioner/physician assistant only)
4. Childrens Special Healthcare Services Provider Attestation (if applicable)
5. Email completed application and required documents to providernetwork@hap.org. Put “new physician application” in subject line.

Individual and group optometrists and ophthalmologists who want to provide routine vision services for eligible HAP members, must participate with the EyeMed Insight provider network.

• If you’re already in the EyeMed Insight network, there is nothing you need to do.
• If you’re not in the EyeMed Insight network, visit eyemedinfocus.com/join/