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

November 2017

Highlights
Webinar for Genetic Testing Authorization

Next month, Harvard Pilgrim and AIM Specialty Health are hosting a webinar for providers who want to learn more about the genetic/genomic and molecular testing program.

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Update: 3D Mammography Coverage

Effective for dates of service beginning Jan. 1, 2018, Harvard Pilgrim will cover digital breast tomosynthesis (DBT), commonly known as 3D mammography, for screening or diagnostic purposes in all states.

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Update: Commercial Medical Transportation Policy

Harvard Pilgrim further updated and clarified our policy requiring prior authorization for non-emergent transportation for our commercial members.

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Clarification on Inpatient Acute Medical Admissions Policy

In the September 2017 issue of Network Matters, Harvard Pilgrim published an article informing providers that effective Nov. 15, 2017, we are extending the timeframe from 7 days to 30 days for what Harvard Pilgrim considers to be a readmission for diagnosis-related groups (DRGs) and global case rate facilities.

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Update to Evaluation and Management Payment Policy

Harvard Pilgrim is updating our Evaluation and Management Payment Policy, effective for dates of service beginning Dec. 15, 2017.

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Network Matters Archives

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HPHCURRENT EVENTS

Streamlining Provider Enrollment and Credentialing Processes

Webinar for Genetic Testing Authorization

2018 Star Ratings Measure Quality and Patient Satisfaction

CLINICIAN CORNER

Update: 3D Mammography Coverage

Update: Commercial Medical Transportation Policy

Members’ Rights and Responsibilities

PCPs and Behavioral Health Care Providers — Working Together

OFFICE ASSISTANT

Clarification on Inpatient Acute Medical Admissions Policy

Update to Evaluation and Management Payment Policy

Accident/Injury Questionnaire for Members

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator