Become a provider

Download our credentialing policy (PDF) to learn about:

• Our credentialing standards requirements and procedures
• Your right to review information obtained from outside sources to support your application
• Your right to correct erroneous information
• Your right to be informed of your application status throughout the credentialing process

To be credentialed with us, please choose the appropriate drop down and follow the instructions.

Instructions

Refer to registration instructions.

Password/Username Reset

Forgot Password

1. Go to the eApply home page. Select Forgot your password?
2. Enter the user name you used to register and select Email link.
3. We will email you a link to reset your password. It will be sent to the email you used to register.

Forgot User name

1. Go to the eApply home page and select Forgot your user name?
2. Enter the email you used to register.*
3. We will email you a link to reset your user name. It will be sent to the email you used to register.

*If you forgot the email you used to register, please follow the guidelines below.

Still having trouble accessing eApply?

Please email providernetwork@hap.org and put “eApply Password Reset” and in the email include:

• The name associated with your application (Practitioner, Group, or Facility name).
• Provider NPI.
• The email address you used to register the provider, if available.
• Brief description of the issue. 
  
   

Required Documents

Downloadable Forms 

• Collaborative Physician Agreement (Nurse Practitioners and Physician Assistants only)
• Disclosure of Ownership and Control Interest Form
• MAHP Children's Special Healthcare Services Attestation (primary care physicians only)
• MAHP Cultural Competency Attestation
• MAHP Provider Enrollment Form

Definition

Groups are a provider entity that is not credentialed separately; however, its related practitioners may require credentialing.

Instructions

1. Click here to review a list of group specialty types.
2. Email providernetwork@hap.org.
3. Put Group Enrollment Request in the subject line.
4. Include the following information:
   1. Tax ID
   2. Type 2 NPI
   3. Type 2 Group Name
   4. Group Specialty Type
   5. Physician Hospital Organization/Physician Organization Name (Please indicate if not affiliated with a PHO/PO)
   6. Primary address

Next Steps

1. We will review your request and email you the application link.
2. Be sure to refer to the Important Registration Instructions drop down before you register for access.
3. Complete the application. Upload appropriate documents - Refer to the Required Documents drop down. E-sign the application and submit.
4. We’ll email you when the enrollment process is complete. Remember, you can’t treat our members until you receive your effective date.

Help Guide

• eApply Help Guide – Group June 2026

 Definition

Individual practitioners are type 1 providers— a licensed individual who provides medical or clinical care, such as a physician, nurse practitioner, therapist, or other healthcare professional. They can be credentialed or not credentialed.

Important !

• Practitioners must be associated with a Health Alliance Plan participating group type 2 NPI to proceed with enrollment
  • Affiliated group not participating with Health Alliance Plan by Henry Ford Health:
    • Please refer to the group drop down and follow the instructions. After you receive notice the group application was completed, you can follow the instructions below.
  • Affiliated group already participating with Health Alliance Plan by Henry Ford Health:
    • Please follow the instructions below.
• Health Alliance Plan requires participation in Medicare. If you don’t participate, please visit this page once Medicare # is obtained

Instructions

1. Email providernetwork@hap.org
2. Put Individual Practitioner Enrollment Request in the subject line
3. Include the following information
   1. Practitioner Name
   2. Type 1 NPI
   3. Tax ID
   4. PO/PHO Name (Please indicate if not affiliated with a physician organization/ physician hospital organization)
   5. Practitioner specialty
   6. Primary address

Next Steps

1. We will review your request and email you the application link.
2. Be sure to refer to the Important Registration Instructions drop down before you register for access.
3. Complete the application. Upload appropriate documents - Refer to the Required Documents drop down. E-sign the application and submit.
4. We’ll email you when the enrollment process is complete. Remember, you can’t treat our members until you receive your effective date.

Help Guide

• eApply Help Guide - Individual Practitioner Credentialed June 2026
• eApply Help Guide - Individual Practitioner Not Credentialed June 2026
   

Definition

Facilities are organizations/entities that require credentialing.

Instructions

1. Click here to review a list of facility specialty types.
2. Email providernetwork@hap.org
3. Put Facility Enrollment Request in the subject line
4. Include the following information
   1. Tax ID
   2. Type 2 NPI
   3. Physician Hospital Organization/Physician Organization Name (Please indicate if not affiliated with a PHO/PO)
   4. Facility Name
   5. Facility specialty type
   6. Primary address

Next Steps

1. We will review your request and email you the application link.
2. Be sure to refer to the Important Registration Instructions drop down before you register for access.
3. Complete the application. Upload appropriate documents - Refer to the Required Documents drop down. E-sign the application and submit.
4. We’ll email you when the enrollment process is complete. Remember, you can’t treat our members until you receive your effective date.

Help Guide

• eApply Help Guide – Facility Application June 2026

Audiology, Hearing, and Vision Providers

To provide hearing aid services for Health Alliance Plan and HAP CareSource members, you must participate with the NationsHearing provider network. If you aren’t participating and would like to join, contact NationsHearing by:

• Phone: (800) 921-4559
• Email: network@nationshearing.com

Vision Providers

Individual and group optometrists and ophthalmologists who want to provide routine vision services for eligible Health Alliance Plan members, must participate with the EyeMed Insight provider network.

• If you’re already in the EyeMed Insight network, there is nothing you need to do.
• If you’re not in the EyeMed Insight network, visit eyemedinfocus.com/join/
   

Important!

Pharmacists must be associated with a Health Alliance Plan participating group type 2 NPI to proceed with enrollment.

• Please refer to the group drop down and follow the instructions. After you receive notice the group application was completed, you can follow the instructions below.
• Affiliated group already participating with Health Alliance Plan by Henry Ford Health:
  • Please follow the instructions below.

Instructions

1. Email providernetwork@hap.org

2. Put Pharmacist Enrollment Request in the subject line

3. Include the following information

• Pharmacist Name
• Type 1 NPI
• Tax ID
• Primary address

Next Steps

1. We will review your request and email you the application link.
2. Be sure to refer to the appropriate eApply Help Guide below before you register for access.
3. Complete the fields, upload appropriate documents, e-sign the application and submit.
4. We will email you when the enrollment process is complete. Remember, you can’t treat our members until you receive your effective date.

Required Documents – Need to know what is required for pharmacist

Click here for a list of required documents (e.g., copies of licenses, liability certificates, etc.)

Downloadable Forms from Required Documents

• Health Alliance Plan Disclosure of Ownership and Control Interest Form

Help Guide

• eApply Help Guide - Individual Practitioner Not Credentialed June 2026