Care And Disease Management

HAP CareSource™ offers care and disease management that can provide a broad spectrum of educational and follow-up services for your patients.

Care Management Program

HAP CareSource’s Care Management program is a fully integrated health management program that strives for member understanding of and satisfaction with their medical care. This one-on-one personal interaction with outreach specialists and nurse care coordinators provides a comprehensive safety net to support your HAP CareSource patient through initial and ongoing assessment activities, coordination of care, education to promote self-management and healthy lifestyle decisions. In addition, we help connect your patient with additional community resources.

HAP CareSource encourages you to take an active role in your patients’ Care Management programs and participate in the development of individualized care plans to help meet their needs. Together, we can make a difference.

You can now access care plans online through the HAP CareSource Provider Portal to easily provide input into your patients’ care plans and consult with care managers.

Children’s Special Health Care Services

If your patient has a serious chronic medical condition, they could be eligible for Children’s Special Health Care Services (CSHCS) plan. This program services children (and some adults) with special health care needs at no cost to the member. HAP CareSource collaborates with providers for CSHCS enrollees. If you have questions regarding your patient, please contact the Care Management department at 1-844-217-1357, Monday through Friday from 8 a.m. to 5 p.m.

Health Care Transition

The Health Care Transition (HCT) program facilitates the process of moving from a child/family-centered health care model to an adult/patient-centered model, starting prior to the age of 14 and continuing into young adulthood for CSHCS enrollees. The goal of HCT is to assist youth in achieving independence in self-managing their health care needs as they enter adulthood.

Hepatitis C Treatment

Hepatitis C Virus (HCV) is the most common bloodborne infection in the United States. People with HCV often do not feel sick and when they do, it is often a sign of advanced liver disease. The CDC recommends screening at least once in a lifetime to all adults 18 and up, as well as with each pregnancy.

Michigan’s We Treat Hep C Initiative increases access to necessary medications such as MAVYRET for Medicaid beneficiaries by removing the prior authorization requirements and dispensing the medication in an eight-week supply (or a 12-week supply, when appropriate). This allows your patients to begin treatment the same day as their diagnosis. HAP CareSource collaborates with providers to promote access and medication adherence. For question or to discuss a patient, pharmacists are available at 1-833-230-2102. Additional resources can be located online. View the Navigate HEP C Virus Frequently Asked Questions for Providers to learn more.

Elevated Blood Lead Level Program

There is no safe level of lead in the blood. If your patient has an elevated blood lead level and needs assistance coordinating resources, please contact the Care Management department at 1-844-217-1357, Monday through Friday from 8 a.m. to 5 p.m. or submit a referral via the HAP CareSource Provider Portal. 

HIV Resources

The Ryan White HIV/AIDS Program (RWHAP) provides a comprehensive system of HIV primary medical care, medication and essential support services to more than half a million people diagnosed with HIV in the United States.

How to Refer Members to Care Management

If you have a patient with a chronic condition who you believe would benefit from support and they are not currently enrolled, please call 1-844-217-1357. The Care Management team can also facilitate referrals to assist with palliative care needs. If you have a patient who can benefit from palliative care services, please call our Care Management team.

Disease Management Support

Our free Disease Management Support helps our members find a path to better health through information, resources and support.

We help our members through:

  • The MyHealth online program for members 18+ to participate in a journey to improve their health
  • Newsletters with helpful tips and information to manage their disease, promote self-management skills, and provide additional resources
  • One-to-one care management

Members with specific disease conditions such as asthma, diabetes, chronic kidney disease, end stage renal disease, and hypertension are identified by criteria or triggers such as emergency room visits, hospital admissions, and the health assessment. All ages (children, teens, and adults) are eligible. These members are automatically mailed condition-specific newsletters. Any member may self-refer or be referred to receive disease management support and condition-specific information or outreach. If a member does not wish to receive information or outreach, they can call 1-844-217-1357.

Benefits to Members and Health Partners

Members identified for Disease Management Support receive help finding the appropriate level of care for their condition, and they are encouraged to actively participate in the patient-provider relationship. The program improves the percentage of HAP CareSource members who receive their recommended screenings.

How to Refer Members with Disease Specific Conditions

If you have a patient with asthma, diabetes, CKD, ESRD or hypertension who you believe would benefit from disease management support and is not currently enrolled, please call 1-844-217-1357.

Health Needs Assessment

HAP CareSource ask that all Traditional Medicaid members complete the Health Needs Assessment (HNA). Through a few questions about the member’s health and well-being, HAP CareSource can help identify health, housing, education and employment concerns where we may be able to help.

Members can complete the HNA one of the following ways:

  1. Online: Visit my.caresource.com, click on your MyCareSource account and then the “Health” tab in the top navigational bar and select, “Assessment”.
  2. Print: New members can complete the printed copy of the HNA included in their new member packet. It can be returned in the enclosed self-addresses, postage paid envelope.
  3. Phone: Call our Member Assessment Team at 1-833-230-2011 (TTY: 711). They can be reached Monday through Friday from 8 a.m. to 6 p.m.

Health Risk Assessment

HAP CareSource Healthy Michigan Plan members are required to complete a health risk assessment (HRA) every year. Within 60 days of enrollment, members are encouraged to schedule an appointment with their primary care provider (PCP). Members are asked to take the HRA to the appointment. Our Member Assessment Team will reach out to members and assist with completing the form, which is then entered into Guiding Care.

Incentive for Providers

HAP CareSource offers a $25 incentive for PCPs who complete and return an HRA for their HAP CareSource Healthy Michigan Plan patients. Incentives are paid quarterly. Below are the steps for competing the HRA:

  1. The member completes sections 1-3 of the form.
  2. The doctor completes section 4 and signs the form.
  3. The doctor faxes the completed form to HAP CareSource at 1-844-633-0393 or to CHAMPS.
  4. The doctor gives the member a completed, signed copy of the HRA.

The doctor bills with CPT coded 96160. The transaction will appear on the remittance advice and be submitted to the Michigan Department of Health and Human Services (MDHHS) as an encounter.