Harvard Pilgrim now offers PPO and Open Access HMO products in Connecticut. Since we entered the Connecticut market, employers, members, and providers throughout the state have recognized what sets us apart. For more than 35 years, Harvard Pilgrim has built a reputation for exceptional clinical quality, preventive care, disease management programs, and member and provider satisfaction. You can feel confident in partnering with an organization that’s consistently ranked among the nation’s highest-rated private health plans.*We are dedicated to offering our Connecticut partners a full range of resources and support.
Tools and Resources
We strive to offer unparalleled service for our providers, lightening your administrative burden so you can do what you do best — care for your patients. The following tools and resources make getting started with Harvard Pilgrim simple:
- Our Quick Reference Guide offers a summary of important information
- Our easy-to-use electronic tools support a variety of self-service e-channels to perform a full range of transactions, including: verifying patient eligibility, submitting and tracking claims, sending and receiving referrals, and more. Our acclaimed web-based transaction service HPHConnect includes analytics to help providers manage accounts receivable, identify trends, and drill down to claim details.
- Our online Provider Manual is your source for payment policies, billing procedures, clinical guidelines, preventive care recommendations, information on disease management programs, medical record-keeping practices, confidentiality policies, and member rights and responsibilities.
- Our monthly e-newsletter Network Matters keeps you and your office staff informed of important news and updates.
- Our online video training presentation offers you and your office staff an overview of Harvard Pilgrim’s history and mission and our products in Connecticut, as well as the information you need (claims, billing, authorizations, etc.) to conduct business with us.
Growing Our Network
We have made great progress in joining with health care systems in Connecticut, and are continuing to develop partnerships with Connecticut providers. If you would like to participate in our network, please send your request for an application to:
Harvard Pilgrim Health Care
ATTN: Network Services, Connecticut Division
1600 Crown Colony Drive
Quincy, MA 02169
Our Staff is Here to Help
Our Provider Relations team provides training and education on policies, procedures, and new initiatives, as well as help with using online tools and resources. For assistance with any of these matters or to schedule onsite training, please contact our Connecticut Provider Relations Consultants at 877-594-7190.
For all other questions, please contact our Provider Service Center at 866-691-8882.
* NCQA’s Private Health Insurance Plan Rankings, 2011-15, HMO/POS/PPO. NCQA’s Health Insurance Plan Rankings 2010- 11 – Private. U.S.News/NCQA America’s Best Health Insurance Plans 2005-2009 (annual). America’s Best Health Insurance Plans is a trademark of U.S.News & World Report. NCQA The State of Health Care Quality 2004.