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Harvard Pilgrim welcomes HPI members
September 2005

HPI has been successful at developing products and services to businesses with as few as 70 employees to those that have well over 1,000. Currently, approximately 81,000 members receive health, dental and short-term disability benefits through self-insured plans administered by HPI.

"Having Health Plans, Inc. as a subsidiary will enhance our capacity to offer a full range of health benefit options and solutions to employers in Massachusetts, Maine and New Hampshire," says Charlie Baker, president and CEO of Harvard Pilgrim. "We believe that adding their expertise in developing products and services for the self-insured market to Harvard Pilgrim's top-rated performance in clinical quality and service will be a winning combination."

Harvard Pilgrim's Senior Vice President of Sales and Marketing Vin Capozzi adds, "This is a great fit that will strengthen our ability to serve those businesses that have chosen to self-insure and want custom-designed plans or separately priced services."

Our products and provider network—as well as HPI's existing product offerings—will be offered to HPI customers as of January 1, 2006. For our products, Harvard Pilgrim will be solely responsible for contracting, credentialing, provider relations, fee schedules and payment policies, and our Provider Manual, and standard policies and procedures will continue to govern the relationship between Harvard Pilgrim and our provider network. HPI will provide administrative services, such as routine provider service center functions and claims processing.

Providers caring for members of Harvard Pilgrim accounts administered by HPI will submit claims directly to HPI in paper form through the mail to Health Plans, Inc., P.O. Box 5199, Westborough, MA, 01581 or to fax number 508-754-9664, or send electronic claims to HPI through WebMD (payor #44273). HPI is currently working on expanding its solutions for submitting electronic claims.

Providers will be able to identify Harvard Pilgrim members by specially designed member identification cards, which will bear both the HPI and Harvard Pilgrim logos. To verify member eligibility, check on claims status or for other administration-related questions, providers should contact HPI's Claims Call Center, which will be available from 8:30 a.m. to 5:00 p.m., Monday through Friday. Outside these hours, providers will be able to leave a voicemail message, which will be addressed the following business day.

For more information about Health Plans, Inc., visit their Web site, www.healthplansinc.com. Further details on provider servicing of Harvard Pilgrim accounts administered by HPI will be available in future issues of Network Leader.

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