...get paid for your mileage. To get paid, call: 1-833-230-2053 (TTY: 711) Monday through Friday from 7:30 a.m. to 8 p.m. You’ll need to fill out a form, have your...

...Comprehensive Formulary Last updated on 12/01/2025 For information about changes to our formulary, please review the Notice of Formulary Changes below. For the most up-to-date formulary information, use our online...

...to keep information current. 2022 Comprehensive Formulary ( English | Spanish (Updated 12/01/2022) – for Ohio only) For information about changes to our formulary, please review the Notice of Formulary...

...See other CareSource forms. This form allows caregivers to work with HAP CareSource on behalf of their loved ones. Member Consent/HIPAA Authorization Form Grants permission for HAP CareSource to speak...

...Cessation Campaign for the U.S. Military Military Service Members and Veterans | For Specific Groups | Tips From Former Smokers | CDC This toolkit was developed for a broad continuum...

...submissions. Alternative Option: Paper Claims Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. Refer to the Provider Manual for instructions to...

...that addresses children and adolescents Be based on perinatal care, care for children up to 24 months of age, care for children 2-19 years of age, care for adults 20-64...

...2017 Policy Release 07/27/2017 Update on Behavioral Health Denials for Code X50 07/26/2017 Behavioral Health Respite Care Services for Children 07/18/2017 Blood Lead Testing Recommendations 07/05/2017 Update on Configurations for...

...is free for you. How can I get information sent to me in paper form? You can request information be sent to you in paper form. This is at no...

...Change Form. Once complete, email the form to providernetwork@hap.org with the subject line: Provider Change Form. In the body of the email, be sure to include: Type 1 NPI Type...