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Home > Providers > News Center > Network Matters

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

April 2015

Highlights

Prior Harvard Pilgrim 2015–2016 GIC Offerings

Harvard Pilgrim and the Group Insurance Commission (GIC) are updating our product offerings for the 2015–2016 plan year, which takes effect on July 1, 2015.

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ACA Update: Fluoride Varnish and Hepatitis B Screenings

EAs part of the Affordable Care Act (ACA), effective May 1, 2015, two new preventive care benefits will be available to members without cost-sharing when the services are administered by an in-network provider.

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Prior Authorization of Select Surgical Procedures

On an ongoing basis, Harvard Pilgrim reviews our medical policies to ensure that they reflect the most current evidence-based clinical guidelines and support care that is medically necessary, clinically effective, and cost efficient.

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Medical Policy for Esophagogastroduodenoscopy

Based on a thorough clinical analysis and review of the competitive landscape, Harvard Pilgrim has developed a new medical policy for reimbursement of esophagogastroduodenoscopy (EGD).

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HPHCURRENT EVENTS

Harvard Pilgrim 2015–2016 GIC Offerings

ACA Update: Fluoride Varnish and Hepatitis B Screenings

CLINICIAN CORNER

Prior Authorization of Select Surgical Procedures

Medical Policy for Esophagogastroduodenoscopy

Coverage for Reclast

P&T Committee Updates

Posttraumatic Stress Disorder’s Effect on Physical Health

OFFICE ASSISTANT

Reminder: Appointment Availability Standards

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator