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Referral/Notification/Authorization

E-Channel Connectivity

  • HPHConnect
  • EDI-Direct CAQH CORE SOAP- Phase IV
  • NEHEN
  • NEHENNet

HPHConnect

  • PCPs can send referrals to specialists in minutes and receive notification when your patients are admitted to a hospital or receive certain services.
  • Specialists can get immediate, online delivery of referrals, so referrals arrive before you see patients and get instant, online transaction number from Harvard Pilgrim.
  • Specialists can know the scope of services expected, plus number of visits recommended by a PCP.
  • Submit service notifications and authorization requests online. Get instant confirmation of receipt by Harvard Pilgrim.
  • Receive online authorization for elective procedures within 24 hours of receipt of necessary medical information. and verify that Harvard Pilgrim has authorized services before they are rendered.

NEHEN/NEHEN Net/Core IV

  • PCPs can send referrals to specialists in minutes using the NEHEN/NEHEN Net online entry or through a 278 request transaction.
  • Specialists can know scope of services expected, plus number of visits recommended by a PCP using the NEHEN/NEHEN Net online portal or through a 278 inquiry transaction.
  • Submit service notifications and authorization requests online. Get instant confirmation of receipt by Harvard Pilgrim.
  • Receive online authorization for elective procedures within 24 hours of receipt of necessary medical information and verify that Harvard Pilgrim has authorized services before they are rendered.

Additional Resources:

To initiate a request to submit referral, notification and authorization transactions directly or for other questions:

Call the EDI team at 800-708-4414, option 1, option 3, or email edi_team@hphc.org


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E-Contacts
EDI Team
(800) 708-4414
(Option 1; then
press 3)

HPHConnect
(800) 708-4414
(Option 1; then
press 6)

NEHEN
781-907-7210
www.nehen.org


Resources:

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