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

February 2017

Update: Expanded Coverage for Esophagogastroduodenoscopy (EGD)


Harvard Pilgrim considers the use of esophagogastroduodenoscopy (EGD) — a test used to examine the lining of the esophagus, stomach and the duodenum —medically necessary for the diagnosis of numerous conditions outlined in our Esophagogastroduodenoscopy (EGD) Medical Policy. Effective for dates of service beginning April 1, 2017, for members age 18 and older, Harvard Pilgrim has updated this policy to include additional covered procedure codes and conditions. For a complete list of covered conditions, please refer to the updated Esophagogastroduodenoscopy (EGD) Medical Policy.

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HPHCURRENT EVENTS

2016 Physician Group Honor Roll Announced

CLINICIAN CORNER

Newborn Level II-IV/NICU Admission Notification Policy

Prior Authorization for Non-Emergent Transportation

Update: Expanded Coverage for Esophagogastroduodenoscopy (EGD)

GERD: Endoscopic Treatments Medical Policy Updated

Updates to Artificial Cervical Disc Replacement Policy

Reminder: 90-day Supplies at Retail

Coordinating Care to Manage Weight Gain in Behavioral Health Patients

OFFICE ASSISTANT

Provider Manual Update and Balance Billing

Moderate Sedation Reimbursement for GI Endoscopic Procedures

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator