State Hearing and External Review

State Fair Hearing Process

You may file a request for State Fair Hearing if you are not satisfied with the decision of your internal appeal. You must file your request in writing within 120 calendar days of the date the appeal denial notice is mailed to you.

Please call Member Services if you have any questions. You may also write to us at:

HAP CareSource
Attn: Grievance & Appeals
P.O. Box 1025
Dayton, OH 45401-1025

Please call us if you have any problems reading or understanding this information. We can read this out loud for you, in English or in your primary language. We also can help you if you are visually or hearing impaired. We can provide language services to help you file a complaint or appeal at no cost to you.

Member Services: 1-833-230-2053 (TTY: 711), 24 hours a day, seven days a week.

External Review of Appeals

You may file a request for State Fair Hearing if you are not satisfied with the decision of your internal appeal. You must file your request in writing within 120 calendar days of the date the appeal denial notice is mailed to you.

You can ask for an external review with DIFS under the Patient’s Right to Independent Review Act – PRIRA. You must do this within 127 calendar days from the date of your appeal denial notice. An External Review form will be included with the notice of appeal decision that you receive from us. It has instructions that you will need to review. You can submit the form to:

Michigan Department of Insurance and Financial Services (DIFS) – Office of Research, Rules, and Appeals – Appeals Section
P.O. Box 30220
Lansing, MI 48909-7720

Fax: 1-517-284-8838
Email: DIFS-HealthAppeal@michigan.gov.

Please call Member Services if you have any questions.

Please call us if you have any problems reading or understanding this information. We can read this out loud for you, in English or in your primary language. We also can help you if you are visually or hearing impaired. We can provide language services to help you file a complaint or appeal at no cost to you.

Member Services: 1-833-230-2053 (TTY: 711), 24 hours a day, seven days a week.