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

January 2013

Provider Claim Reporting Update


Beginning in February, Harvard Pilgrim will be enhancing Provider Claim Reporting for providers enrolled in HPHConnect. Provider Claim Reporting is Harvard Pilgrim’s free electronic reporting tool that enables providers to monitor and manage their practice’s claims activity. Data reports are produced monthly.

While users may notice changes to the tool's interface and improvements in response times, the overall look and feel of the application will remain familiar. Harvard Pilgrim will post an updated user guide in February.

Provider Claim Reporting is available only to those with an HPHConnect account. Users can:

  • Easily manage accounts receivable, identify trends, quickly drill down to claim details, and reduce unnecessary administrative denials
  • View claims, EDI, and provider demographic data for practitioners and groups with an authorized HPHConnect access list
  • Access 13 months of adjudicated claims, detailed EDI submission data, and demographic details on associated providers for Harvard Pilgrim members enrolled in Harvard Pilgrim core HMO, POS, and PPO products
  • View reports, submit requests, see remittance check status summary reports, and retrieve available download requests submitted within the previous 15 days

For more information about Provider Claim Reporting, call your provider relations consultant. To learn more or to register, visit the HPHConnect page.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network and Product Development

Joann Peck,
Manager, Network Planning and Administration

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator