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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2016

Update to Appeals Filing Limit for Medicare Advantage Plans


Effective February 1, 2017, Harvard Pilgrim is updating the appeals submission process for our StrideSM (HMO) Medicare Advantage plan. For participating providers, Harvard Pilgrim is changing the allowed timeframe for submission of claims appeals for Stride (HMO) Medicare Advantage to 90 days from the date of the initial denial notice on your explanation of payment. A different time frame applies for non-participating providers due to Centers for Medicare and Medicaid Services (CMS) requirements; non-participating providers must file an appeal for a denied claim within 60 days of the denial.

If you have any questions, please contact the Medicare Advantage Provider Service Center at 888-609-0692.

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    PUBLICATION INFORMATION

    Eric H. Schultz,
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