The Centers for Medicare & Medicaid Services and other regulatory bodies require health plans to maintain and update data in provider directories, and we rely on our providers to review their data and notify us of any changes as they happen to ensure that members have access to accurate information.
As we announced in the October 2018 issue, Harvard Pilgrim is participating in efforts through HealthCare Administrative Solutions to institute a centralized process for providers (using CAQH’s DirectAssure®) to review and report changes to demographic data. Harvard Pilgrim will share implementation updates in future issues of the newsletter. Providers may also visit the HCAS website to learn more.
While we work on implementation, continue to use existing processes to review and report changes to your address, panel status (open or closed) for each individual provider, institutional affiliations, phone number, and other practice data. You may review this information via our online Provider Directory. If you need to update any information, please fill out a Provider Change Form
and submit it to Harvard Pilgrim’s Provider Processing Center by email at PPC@harvardpilgrim.org.
Notification of address, panel status, and other demographic information changes should be submitted at least 30 days in advance. For any further questions, call the commercial Provider Service Center at 800-708-4414 or the Medicare Advantage Provider Service Center at 888-609-0692.