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

April 2019

Submitting Claims for Fidelity, Sedgwick, and Nielsen Members


Please keep the following information in mind regarding the correct process for submitting claims for Fidelity Investments, Sedgwick Claims Management Services, and Nielsen members. As a result of the partnership Health Plans, Inc. (HPI), a Harvard Pilgrim company, has with UMR (UnitedHealth Care’s third-party administrator solution), HPI manages claims from Massachusetts, New Hampshire and Maine providers for Fidelity, Sedgwick, and Nielsen members, whereas UMR manages claims from Connecticut, Rhode Island, and Vermont providers for these members. This took effect on Jan. 1, 2019.

Submitting Claims for Fidelity, Sedgwick, and Nielsen Members

Provider State

Submit Claims

MA, NH, ME

Electronic: HPHC Payer ID# 04271

HPHConnect, NEHEN, NEHENNet: Claims will be transferred to HPI for processing.

Web/MD Change Health: Use HPI’s Payer ID# 44273

Paper: Mail to Health Plans Inc., P.O. Box 5199, Westborough, MA 01581

CT, RI, or VT

UMR

Electronic: Payer ID# 39026

Paper: UMR, P.O. Box 30541, Salt Lake City, UT 84130-0541

Note: If you submitted a claim for these members to an incorrect address and received a rejection message, you must resubmit the claim to the appropriate address noted above to ensure receipt of claim and appropriate processing.

Recognizing members

You can recognize members of the Fidelity, Sedgwick, and Nielsen plans by their ID cards, which display the Harvard Pilgrim logo on the front of the card and the HPI logo on the back (see the sample below). In addition, the electronic eligibility response will display the plan name as Health Plans HPHC UMR UHC PPO.

Please note that while HPI members typically are assigned member ID numbers beginning with HH, this is not the case for the Fidelity, Sedgwick and Nielsen members.

For your reference, the group numbers for these accounts is as follows:

  • Fidelity Group # 76-413512
  • Nielson Group # 76-413554
  • Sedgwick Group # 76-413489

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PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator