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

June 2018

Follow-up WebEx on Reducing Avoidable Hospital Admissions

As communicated in this article from last month’s issue of Network Matters, Harvard Pilgrim medical directors, the medical leaders of participating hospitals and provider organizations, and other local industry leaders discussed the importance of decreasing avoidable emergency department visits and hospital readmissions at the most recent Massachusetts Medical Directors’ Meeting.

Harvard Pilgrim is continuing that discussion by hosting a follow-up WebEx that will offer the opportunity for our providers to share ideas about avoiding hospital readmissions and address common challenges, possible solutions, and best practices. Speakers from Emerson Hospital and Atrius Health will also present what they have done to improve readmission rates in their populations.

The WebEx will take place on Thursday, June 14 at noon (EST). If you’re interested in participating in the WebEx, send an email containing your first and last name to Ellen Foley at Ellen_Foley@harvardpilgrim.org and you will receive an invite via Event Registration.

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Network Matters Archives

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New Program Rewards Medicare Advantage Patients for Healthy Behaviors

GIC Product Updates Effective July 1

Introducing New Hampshire POS Open Access Plans

Harvard Pilgrim Grant Announcements


Coverage of Higher Dosage of Lupron Depot for Breast Cancer

Benign Prostatic Hypertrophy Medical Policy Updates

Cryotherapy for Prostate Cancer Requires Prior Authorization

Coverage of Fecal Calprotectin Testing

Lutathera Covered with Prior Authorization

Updates to TMJ Prior Authorization Policy

Prior Authorization No Longer Required for Cologuard Test

Follow-up WebEx on Reducing Avoidable Hospital Admissions


Negative Balance and Refund Process Enhancements

Enhanced Processes and Communication with Providers

Keep Panel Status and Demographic Information Up to Date

Early Intervention Provider Fee Schedule Update

2018 Home Care Seasonal Flu Vaccine Fee Schedule

Documenting Deep Vein Thrombus and Pulmonary Embolism


Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator