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

February 2019

Highlights
HPHConnect for Providers Updated with New Look and Functionality

If you haven’t used HPHConnect for Providers lately we encourage you to visit the portal to see the new look.

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2019 Physician Group Honor Roll Announced

Harvard Pilgrim would like to congratulate the 62 physician groups in Massachusetts, Maine, and New Hampshire named to our 17th annual Physician Group Honor Roll.

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Reminder: UM Decision-Making and Communications

As a reminder, Harvard Pilgrim has established policies and procedures that govern our utilization management program.

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Retacrit Now Covered with Prior Authorization

Harvard Pilgrim now covers the medication Retacrit for members of our commercial plans.

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Medicare Advantage: Report Primary Diagnosis Codes in Primary Position

For dates of service beginning April 4, 2019, when a claim is submitted for a StrideSM (HMO) Medicare Advantage member that includes a Z code with a Primary Diagnosis Only (PDO) requirement, the Z code must be reported as the principal diagnosis for an institutional claim or primary/first-listed diagnosis for a professional claim.

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Network Matters Archives

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HPHCURRENT EVENTS

HPHConnect for Providers Updated with New Look and Functionality

2019 Physician Group Honor Roll Announced

CLINICIAN CORNER

Reminder: UM Decision-Making and Communications

Retacrit Now Covered with Prior Authorization

Harvard Pilgrim No Longer Covers Cooling Devices

Members’ Rights and Responsibilities

OFFICE ASSISTANT

Medicare Advantage: Report Primary Diagnosis Codes in Primary Position

2019 Fee Schedule Updates

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator