Forms and other information

We want it to be easy for you to work with HAP. Here are forms you'll need:

Claims Appeals Form

• Cotiviti and Change Healthcare/TC3 Claims Denial Appeal Form

Provider Change Form

• Provider Change Form - update existing provider information.

Inpatient Rehab and Skilled Nursing Facility Forms

• Inpt Rehab SNF-Admission Precert
• Inpt Rehab SNF-Continued Stay or Auth Discharge Summary
• Inpt Rehab SNF-LTAC Continued Stay Auth
• Inpt Rehab SNF-Wound Care Summary

Prior Authorization information

• Prior Authorization Reform
• Prior Authorization Requirements

After Hours and Appointment Time Access Standards

• After Hours and Appointment Time Access Standards

Facility and medical record standards

• Facility Standards for Practitioners and Providers
• Medical Record Standards for Practitioners and Providers

HAP Quality Program

• For information on HAP’s Quality Program click here.