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Training Descriptions

Harvard Pilgrim provides the following training sessions for office managers and staff via Web conference. To view a description of the training session, click on the title link. 



Harvard Pilgrim Basics


In these Harvard Pilgrim Basics sessions, providers and their office staff will learn about our products, services, and business practices.

Welcome to Harvard Pilgrim
Provides an introduction to Harvard Pilgrim Health Care for all provider specialties and their office staff that may be newly credentialed and/or contracted to perform services to our members. Topics covered in this session include, but are not limited to:

  • Claim submission and appeals
  • E-transaction options
  • On-line resources  
  • Product and member identification
  • Provider service options
  • Referrals and authorizations

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Credentialing & Enrollment
Participants will learn about Harvard Pilgrim's policies and procedures for initial provider credentialing and re-attestation/ re-credentialing of a clinician.  In addition, time is spent reviewing Harvard Pilgrim's requirements for submission of provider enrollment changes.

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Claims Billing
Harvard Pilgrim provides a variety of on-line tools and resources to help providers manage their revenue cycle.  This session will focus on the options available for eligibility verification, referral/notification/authorization submission and conducting claims status inquiries.  Participants will also receive instructions on referencing Harvard Pilgrim's online Provider Manual for resources related to referral/notification/authorization requirements, payment policies, and billing and reimbursement.

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Harvard Pilgrim Technology Solutions

 

EDI Options - Claims & More
Harvard Pilgrim offers many options for provider electronic administrative services. Learn the options available and requirements for claims submission, eligibility inquiry, claims status inquiry, referral and authorization requests and inquiry, as well as receiving the payment remittance advice. Understanding what options may suit a particular provider will also be discussed.

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