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

November 2016

Highlights
Website Redesign: Navigating to the Provider Website

In the next month, Harvard Pilgrim will be unveiling a new design for our website, particularly our home page and member sections. With this redesign, you’ll find the link to the provider page in a different spot.

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Important Referral Reminders for PCPs and Specialists

As a reminder, when a Harvard Pilgrim member is referred for specialty services, the referring PCP and the specialist delivering care should each verify that the PCP making the referral is the PCP of record listed for the member in Harvard Pilgrim’s system.

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Update to Appeals Filing Limit for Medicare Advantage Plans

Effective February 1, 2017, Harvard Pilgrim is updating the appeals submission process for our StrideSM (HMO) Medicare Advantage plan.

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Reminder: Billing for Professional, Technical, and Global Services

Harvard Pilgrim would like to offer providers a reminder on billing for professional services, technical services, and global services.

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HPHCURRENT EVENTS

Website Redesign: Navigating to the Provider Website

Mindfulness CME/CNE Program Offered

CLINICIAN CORNER

Important Referral Reminders for PCPs and Specialists

Coverage of Treatment for HIV-Associated Lipodystrophy

Update to Appeals Filing Limit for Medicare Advantage Plans

Infertility Services Prior Authorization Criteria Updated

Reminder: Billing for Professional, Technical, and Global Services

Diagnosing PTSD and Referral for Treatment

OFFICE ASSISTANT

Update: Sleep Studies Payment Policy

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator