Claims

In addition to information about how to submit claims and check payments, HAP CareSource™ offers you tools to find specific information, such as claim status and member coordination of benefits (COB) status. 

HAP CareSource accepts claims in a variety of formats, including online and paper claims.

HAP CareSource provides several opportunities for you to request review of claim or authorization denials. For additional information regarding the provider disputes and appeals, please visit the Disputes or Appeals webpage. Provider Services Call Center specialists are available to help review your claims and advise of next steps at 1-833-230-2102.

Submit Claims Online

Providers have the option to submit claims through our secure, online HAP CareSource Provider Portal. You can submit claims, track claim payments and more. HAP CareSource offers this service at no cost.

We encourage you to submit claims online to take advantage of the following benefits:

  • Faster claim processing
  • Reduced administrative costs
  • Reduced probability of errors or missing information
  • Faster feedback on claim status
  • Minimal staff training or cost

Refer to the Navigate Provider Manual for detailed information to submit claims.

HAP CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge through the Availity Portal. You can use the Availity Portal Registration Guide.

Get Paid Electronically

If you’re currently set up for electronic fund transfer (EFT) with HAP, there is nothing you need to do.

If you aren’t set up for EFT with HAP, please review the information below.

HAP CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:

  1. EFT – preferred
  2. Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
  3. Paper checks

*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.

Enrollment Instructions

Enroll with ECHO for payment and choose EFT as your payment preference for HAP CareSource.

Questions? Call ECHO Customer Support at 1-833-629-9728.

Paper Claims

For the most efficient processing of your claims, HAP CareSource recommends you submit all claims electronically via the HAP CareSource Provider Portal. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process.

Please send all paper claim forms to HAP CareSource at the following address:

HAP CareSource
Attn: Claims Department
P.O. Box 1186
Dayton, OH 45401-1186

Refer to the Navigate Provider Manual for instructions to submit paper claims.

Nonparticipating Providers

Nonparticipating providers may submit claims to HAP CareSource using the Nonparticipating Provider Profile Form. HAP CareSource is unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form.

Claim Overpayment Recovery Requests and Resources

Navigate Overpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.