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

February 2013

Reminder: Member ID prefixes may not indicate particular products

In the past, Harvard Pilgrim member IDs included prefixes that denoted membership for a specific product or product type (for example, “HPP” for PPO members or “HPK” for Medicare Supplement), but that changed in October 2011 when systems upgrades were made. As we noted in a previous issue of Network Matters, prefixes may no longer indicate enrollment in a particular product or product type.

Upon enrollment, all new members receive IDs with a prefix of “HP,” while existing members keep their current ID numbers. Therefore, to determine product enrollment and to check member eligibility, benefits, and cost sharing information, please use HPHConnect or any of the many options available to submit the HIPAA 270 eligibility request (including NEHEN ,NEHENNet, or CAQH CORE channels) and receive the 271 eligibility and benefits response.

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Reminder: Timing of preventive care visits

P&T Committee Update

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Reminder: CPT code for administering immunizations

Reminder: Member ID prefixes may not indicate particular products


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,

Kristin Edmonston,
Production Coordinator