Noncontracted provider resources
Below is important information and resources for noncontracted providers.
Access to online applications
- Noncontracted providers can access the secure online portal for member eligibility, claims and remittance advices.
- To set up an account, go to our log in page, select "Providers", then "Register" and follow the prompts.
Clinical Criteria
Click here to view our referrals, authorizations, and clinical criteria.
Outpatient medical services prior authorization requests
- Noncontracted providers are required to obtain authorization for all services except emergency. Prior authorization is not a guarantee of payment.
- To request authorization, complete our form or you can call (313) 664-8950, option 1.
Important Information for Non-Contracted Providers
- Travel benefits for Medicare members - We provide our Medicare members with coverage when they travel.
- Surprise medical billing - On October 22, 2020, Michigan state law prohibits surprise billing by nonparticipating providers.
- Merit Based Incentive Payment System Payment Adjustments for Non-Contracted Providers
- Reminder - Medicare Claims Pricer for Ambulatory Surgery Center Claims
- Provider – Waiver of Liability - To file an appeal, a noncontracted doctor or other noncontracted provider who has furnished a service to the enrollee must complete and submit the Waiver of Liability form with their appeal request. This form is required by Medicare and must be received before we can begin to process the appeal. For HAP Empowered MI Health Link appeals, this form applies for Medicare-covered services.