When applying to become a HAP provider, what documents should I submit?

The following list of credentialing documents are required to be received prior to HAP and HPI contracts being sent to you for review and signature.

• State of Michigan License
• CMS Certificate (Medicare letter/number)
• General Liability Certificate ($1M occurrence and $2M aggregate)
• W-9 (version 2007 or later)
• Accreditation Certificate

Ancillary providers please read the Ancillary Facility Contracting Requirement Grid for more details.