Harvard pilgrim provider portal

Harvard pilgrim provider portal. Call us today! (Note: Certain provider specialties are never marketed/listed) 11. Log in to your account. Are you an HPI provider? Access secure tools, resources and provider-specific information to easily manage administrative tasks online. For these members, providers in our service area should work directly with Harvard Pilgrim for behavioral health services, including obtaining prior authorizations, submitting claims, coordinating with care managers, and contacting the Harvard Pilgrim Provider Service Center (800-708-4414) with questions. 1, and Sept. Employer. 117 October 2015 Submit information via: • HPHConnect • Nehen • NehenNet or Complete all fields below and FAX completed form to: 800-232-0816 Patient name: Date of birth: HPHC member ID #: Requesting provider: HPHC provider ID#: NPI#: Person completing form: Telephone #: Fax #: Insights and Updates for Providers; Pharmacy Medical Necessity Guidelines; Payment Policies; Prior Authorization. HPHConnect is a portal for providers to access Harvard Pilgrim Health Care's products, services and resources. Learn more about the prior authorization process in this section. Our family of plans includes standard, tiered, and limited network products, senior plans, and national plans, as well as health benefit administration for self-funded employer groups. Oct 1, 2019 · Labor Day hours: Our Member Services department will be closed on Monday, September 2, for the Labor Day holiday. Jul 1, 2019 · See your own doctors – visit any doctor who accepts Medicare patients. 30 – Sept. on Friday, Aug. to 8 p. HPI is proud to be a Harvard Pilgrim company and partner to BMC. Log in or register to access HPHConnect, a portal for providers to manage authorization, billing, and reimbursement. Use HPHConnect portal to submit requests, verify eligibility, and access other services. Requesting provider *Provider NPI # Phone Fax Diagnosis ICD-9 or ICD-10 code Date of onset/injury / / Date of initial evaluation / / Date of first treatment / / Payment is based on member eligibility and benefit limitation at the time the service is rendered, as well as Harvard Pilgrim provider contractual agreement. Live anywhere in the United States and be enrolled in Medicare Parts A and B. Find prior authorization information, guidelines, forms, and vendor programs for commercial products. The Medicare Advantage Provider Portal Harvard Pilgrim’s easy-to-use Medicare Advantage Provider Portal (see below) supports a full range of transactions, including: • Verifying patient eligibility • Tracking claims • Reviewing prior authorization status • Checking member copays You may register for the Medicare Advantage Provider Portal Tools and resources to assist Harvard Pilgrim network providers, including authorization and payment policies, pharmacy, billing and reimbursement, forms, newsletter, quality programs, and more. These resources provide step-by-step instructions for submitting claims electronically in Harvard Pilgrim Health Care’s secure portal HPHConnect: Professional Claims Submission Guide and our new short video. On this page you’ll find reference materials to guide you and your office staff in coding accurately for services you administer, understanding Harvard Pilgrim payment policies and A Point32Health company. Harvard Pilgrim’s electronic payer ID number is 04271. Notification Requirement . Harvard Pilgrim Health Care Commercial Provider Manual; Stride Medicare Advantage Provider Manual; Tufts Health Plan Commercial Provider Manual; Tufts Health Public Plans Provider Manual Under most Harvard Pilgrim plans, prior authorization is required for the following. Provider. For Harvard Pilgrim Health Care commercial members. Access your secure account. Manage your business. Not sure where to start? Let our website put you on the right path. Until further notice, as a transitionary measure, providers who participate in the UnitedHealthcare network will be considered in-network providers for Harvard Pilgrim. With the update, Contact Name and Contact Info will become required fields when submitting an outpatient service transaction. Additional maintenance is planned for the weekends of Aug. Subscribe to Network Matters for email delivery of provider news and updates. Check eligibility, request authorization and more. 16 through 11 p. For status inquires on your application, please call the Provider Service Center at 1-800-708-4414. Enrollment Form. Electronic Tools & Transactions. Contact Medicare Advantage Provider Service Center at 888-609-0692, if you have questions. Specific items and services require that either your provider or you obtain approval (prior authorization) from Harvard Pilgrim. Back to Harvard Pilgrim Health Care Commercial Provider Manual Member Care Harvard Pilgrim Health Care Commercial Provider Manual. org. Manchester, NH Harvard Pilgrim Health Care 650 Elm Street, Suite 203 Manchester, NH 03101-2596. Sunday, Aug. You’ll also find more information on company achievements, health equity initiatives andPoint32Health’s family of companies, including Harvard Pilgrim Health Care and Tufts Health Plan. Enrollment, billing and other transactions. Quoting, renewals, commissions and more. Harvard Pilgrim operates an oncology medical management program with OncoHealth (formerly Oncology Analytics). Harvard Pilgrim Health Care offers a wide range of plans to meet the needs of members and employers throughout our service area. Provider Tools & Resources HealthTrio connect is a secure portal for HPHConnect users to manage their health plan, claims, referrals, and more. Log in. Visit our website. 1, 2024. Labor Day hours: Our Member Services department will be closed on Monday, September 2, for the Labor Day holiday. on Tuesday, September 3. With the Point32Health Provider site, we aim to make it easy for you to work with us to support our members’ health and wellbeing — including providing you and your office staff with updated information for both our legacy brands, Harvard Pilgrim Health Care and Tufts Health Plan. Learn about performing a variety of transactions (elibility, claim submission and status, referrals, authorization, etc. Network Operations & Care Delivery Management-Resources . In all cases, 30 days written prospective notice to Harvard Pilgrim is required (except concierge style — 90 days required). 23-24, Aug. * Provider/Practice/Facility Name * NPI *Indicates a required field Step 4: Please be sure you have completed the entire Harvard Pilgrim Healthcare Stride for Providers registration process. Call us today! To assist you in caring for our Stride Medicare Advantage members, we've developed these resources. As New England’s health plan of choice, we deliver flexible health plans designed with integrated care models, far reaching provider networks, effective preventive health strategies and robust self-service tools to guide members toward better health. Back to Harvard Pilgrim Health Care Commercial Provider Manual Referral, Notification & Authorization Harvard Pilgrim Health Care Commercial Provider Manual Labor Day hours: Our Member Services department will be closed on Monday, September 2, for the Labor Day holiday. Forgot password or username? Need help with your account? Contact Member Services at (888) 333-4742. New users to the Provider Portal can create an account by selecting the Provider Access Link on the portal login page. Call us today! For help with the use of this website, you may contact our Provider Relations Dept. Quincy, MA Harvard Pilgrim Health Care 1600 Crown Colony Drive It has been developed as a reference tool for the providers and office staff who serve Harvard Pilgrim Health Care and Harvard Pilgrim Health Care of New England members, and contains information intended for all Harvard Pilgrim Health Care providers, including Medicare supplement providers. Log in or register today. Underwritten by HPHC Insurance Company (HPHC) and administered by UnitedHealthcare Student Resources, our student insurance plans offer exceptional affordability and administrative ease for colleges and universities. Provider Tools & Resources Having trouble finding a mental health or substance use disorder provider? Our specially trained Service Navigators can help you find and get the care that’s right for you. Provider Tools & Resources. Provider/Member Relationship. Welcome to Harvard Pilgrim's Provider Portal! Quick and easy access to. New to HPHConnect? Its easy to get started. Look for providers labeled "Premium Care Physician", which indicates the provider meets the criteria for providing quality and cost-efficient care. Prior authorization resources; Provider Manuals. . is a Harvard Pilgrim Resoures for network providers and office staff, including information on joining the network; Forms; Provider Manuals; electronic payment, e-transactions, and HPHConnect; and key contacts. m. See the criteria used to review prior authorization requests Learn more about Point32Health, a not-for-profit health and well-being company based in New England. Depending on the county in which they reside, Medicare beneficiaries can choose from the following Harvard Pilgrim plan options in New Hampshire (Note that Value Rx Plus is the only plan we offer in Strafford County): Harvard Pilgrim Health Care Commercial Provider Manual Oct 20, 2023 · If you are not a contracted Harvard Pilgrim Health Care provider, you may continue to provide uninterrupted care of members through Harvard Pilgrim’s continuity of care plans. Broker. With HPHC’s broad regional network in Maine, Massachusetts and New Hampshire and UnitedHealthcare’s PPO networks in other states, students will have broad access to doctors Harvard Pilgrim Health Care—Provider Manual D. To join our network, please complete and submit the following materials to Harvard Pilgrim’s Provider Processing Center for review. Harvard Pilgrim Health Care is part of Point32Health, a parent organization of Harvard Pilgrim and Tufts Health Plan. Registration Instructions. 2024 . View member eligibility; View and submit referrals; View claims; View other participating providers; Create and manage Users Find information and forms for trading partner agreement, user role update, provider identification, HPHConnect enrollment, EDI enrollment and more. 20-22. For this program, OncoHealth conducts medical review of chemotherapeutic protocols (chemotherapy, support and symptom management drugs) for Harvard Pilgrim commercial and Medicare Advantage members with a cancer diagnosis that requires these services. Our Medicare Advantage representatives will be available on Friday, August 30, from 8 a. Click on a specific provider to view average cost estimates for office visits and treatments for illnesses and conditions within your area. Find it on your device's app store Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Log in to your provider account to check eligibility, request authorization and more. User Guides. Harvard Pilgrim is a leading not-for-profit health services company serving members in Connecticut, Maine, Massachusetts, New Hampshire & beyond. Payspan Provider Services at 877-331-7154 (option 1) or by visiting . For members enrolled in Harvard Pilgrim’s HMO products, prior authorization is required for any elective referral to a non-contracted provider. ), receiving electornic payment, and accessing reports through our web tools. Medical review criteria Referral Portal; Log in to the Referral Portal. ) Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Call us today! Member? Register now! Create a secure account to see your personal health information. We recommend using our portal, HPHConnect, to send or receive specialty referrals, submit authorization requests, and conduct other transactions — and you can easily register or login to HPHConnect below. Learn how to register, update, and use HPHConnect and other electronic tools for faster and easier transactions with Harvard Pilgrim. We'll reopen at 8 a. At the doctor's office, at home or on the go, Harvard Pilgrim's mobile app gives you easy and convenient access to your plan details, ID card and more. Key Dates for 2025 Plans Harvard Pilgrim has a partnership with Evolent (formerly National Imaging Associates, Inc. They can assist with getting timely appointments, connecting you to other Harvard Pilgrim resources and recommending tools to support your needs. To log in, you need a username and password, or you can register if you are new to HPHConnect. Find information and resources on network management, quality, COVID-19, and more. Contact Provider eBusiness Services team at (800) 708-4414 (option 1, then option 6) [email protected] Contact Our Provider Service Centers Provider Service Center Member? Register now! Create a secure account to see your personal health information. com A Point32Health company Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Need help with your account? Contact Provider eBusiness Services team at (800) 708-4414 (option 1, then option 6) [email protected] Contact Our Provider Service Centers. Health Plans, Inc. For Harvard Pilgrim Choice Plus and Options plans, offered jointly with UnitedHealthcare, go to Choice Plus employer services at employereservices. No requirement to choose a primary care provider (PCP) or obtain referrals to specialists (although we recommend having a PCP to coordinate your care. People-forward innovation to drive better health. 18. @ 888-609-0692 Otherwise, type your user Login Id and Password and click the login button. Together, we're delivering ever-better health care experiences to everyone in our diverse communities. Quincy, MA Harvard Pilgrim Health Care 1600 Crown Colony Drive As a result, the Harvard Pilgrim provider website and HPHConnect will not be available starting at 8 p. Tools and resources to assist Harvard Pilgrim network providers, including authorization and payment policies, pharmacy, billing and reimbursement, forms, newsletter, quality programs, and more. This Manual sets forth the policies and procedures that providers participating in the Harvard Pilgrim Medicare Advantage network are required to follow. Provider Tools & Resources Harvard Pilgrim Health Care Institute 401 Park Drive, Suite 401 East Boston, MA 02215-3325. org or 800-708-4414 (select option #1 and then option #3). Our e-transaction services, including our online portal HPHConnect, make it easy for providers to do business with us. Fax your completed Harvard Pilgrim Healthcare Stride Enrollment Form to 866-884-3844, or email attachment to Provider_eBusiness_Services@harvardpilgrim. Nov 1, 2023 · For assistance, please contact Harvard Pilgrim’s Behavioral Health Access Center at 888-777-4742 or access Optum’s Provider Express website for clinical and administrative resources, including the Prior Authorization of Service and the Contact Us (for provider assistance) sections. Find a provider in your network. Use our broker tools. Use this site to learn about your benefits and find a dental provider near you. 60 Apr. Quality Initiatives. Forgot your username? Forgot your password? Registration Information. HPHConnect is a free online portal for providers to access health plan information, submit claims, verify eligibility, and more. Find an overview of our Medicare Advantage plans, our Medicare Provider Manual, handy forms, policies, compliance information, pharmacy resources, our Quick Reference Guide, and more. Harvard Pilgrim is making an update to the electronic prior authorization request submission process in HPHConnect, our online provider portal, which will take effect Nov. In 2024, Harvard Pilgrim Stride SM (HMO)/(HMO-POS) Medicare Advantage plans are available in 10 of 12 counties in New Hampshire. Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. Harvard Pilgrim Health Care Institute 401 Park Drive, Suite 401 East Boston, MA 02215-3325. View member eligibility; View and submit referrals; View claims; View other participating providers; Create and manage Users Point32Health is the parent organization of Harvard Pilgrim Health Care and Tufts Health Plan. HARVARD PILGRIM HEALTH CARE-PROVIDER MANUAL A. /NIA) to oversee prior authorization programs for certain services, including cardiac diagnostic tests and interventional procedures; diagnostic imaging; sleep studies; hip, knee, and shoulder surgery; spine surgery and cervical spine procedures; and outpatient interventional spine pain management services. Harvard Pilgrim offers guidance, information, and resources to help ensure you receive timely, accurate reimbursement for the services you provide to our members. For help with the use of this website, you may contact our Provider Relations Dept. If applicable, what laboratories do you use for diagnostic testing? (Note: Harvard Pilgrim requires the use of participating providers for any diagnostic tests ordered) *If you are requesting to participate in the Harvard Pilgrim provider network as a new group, please provide the As Tufts Health Plan and Harvard Pilgrim Health Care have combined under the parent company Point32Health, many of the resources you routinely access in doing business with Tufts Health Plan have been migrated to the Point32Health provider website. Portland, ME Harvard Pilgrim Health Care 80 Exchange Street, Suite 200 Portland, Maine 04101. If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care’s Electronic Data Interchange (EDI) team at edi_team@point32health. • ‘Harvard Pilgrim Health Care’ for commercial and Medicare Enhance or Medicare . Thank you for your patience as perform these important updates. Harvard Pilgrim’s dental plans support your oral health with exceptional service. mojl ilwngev wgfjyk bjz ena rta pmxd poicq egx wpdoe