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

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

September 2018

New Resource for Reading Provider Adjustments in EOP

Building on previous enhancements to our electronic tools and resources, Harvard Pilgrim has developed the Provider Adjustments in the Explanation of Payment document. This helpful resource highlights how to read and understand the adjustments in the paper Explanation of Payment and the Payspan “Printable View” of the 835 electronic remittance advice.

It also offers details on reading:

  • Provider refunds used
  • Provider refunds returned
  • Forward balance created
  • Forward balance used
  • Forward balance remaining
  • Transfers
  • Write-offs

Some other recent enhancements include updates to payment summary information in the Payspan printable view, the new Negative Balance Report and User Guide, the Refund Report and User Guide, and this document on how to read the 835 provider level adjustments. For more information on these changes, please refer to the February 2018 and June 2018 issues of Network Matters.

For further questions on any of these resources, please contact the Harvard Pilgrim EDI Team at EDI_team@harvardpilgrim.org or call 800-708-4414 (select option 1, then option 3). Also, if you don’t currently have an HPHConnect account, we encourage you to sign up by clicking on the the registration page in the HPHConnect section of Harvard Pilgrim’s provider website and following the instructions.

Email this article to a colleague   

Network Matters Archives

Download printer-friendly version


New Product Offerings Focused on Millennials

Credentialing for Addiction Medicine


GIC Plans: Express Scripts Manages Certain Medical Drugs

Advance Care Planning Coverage

Update: Medical Review Criteria

Criteria Updates for Soliris, Prolia, and Kymriah

Medicare Advantage: Chronic Care Improvement Program for Hypertension


Billing Diagnosis Codes for Preventive Services

Update to Radiology Payment Policy

Appropriate Coding for Urine Drug Testing

Correct ICD-10-Clinical Modification Coding

New Resource for Reading Provider Adjustments in EOP

New Details in Claims Rejections for Member Information


Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator