Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

November 2017

Update to Evaluation and Management Payment Policy


Harvard Pilgrim is updating our Evaluation and Management Payment Policy, effective for dates of service beginning Dec. 15, 2017.

With the update, Harvard Pilgrim’s policy concerning reimbursement for multiple evaluation and management (E&M) services provided to the same patient, on the same day will not distinguish between outpatient and inpatient E&M services. Additionally, reimbursement will be based on federal tax identification number (TIN) and specialty/subspecialty — regardless of whether the visits are for related diagnoses.

If multiple providers in the same billing group (using the same TIN) and of the same specialty provide inpatient or outpatient E&M services to the same patient on the same date of service, Harvard Pilgrim will reimburse only the E&M service with the highest allowable amount.
 
For more information, please refer to Harvard Pilgrim’s updated Evaluation and Management Payment Policy.

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Streamlining Provider Enrollment and Credentialing Processes

Webinar for Genetic Testing Authorization

2018 Star Ratings Measure Quality and Patient Satisfaction

CLINICIAN CORNER

Update: 3D Mammography Coverage

Update: Commercial Medical Transportation Policy

Members’ Rights and Responsibilities

PCPs and Behavioral Health Care Providers — Working Together

OFFICE ASSISTANT

Clarification on Inpatient Acute Medical Admissions Policy

Update to Evaluation and Management Payment Policy

Accident/Injury Questionnaire for Members

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator