Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

August 2019

Highlights
SNF Reimbursement Methodology for Medicare Advantage

Effective for dates of service beginning Oct. 1, 2019, Harvard Pilgrim is updating the reimbursement methodology for skilled nursing facility (SNF) services provided to Harvard Pilgrim StrideSM (HMO) Medicare Advantage members.

Read more


Updates to Commercial Medical Policy for Sandostatin

Harvard Pilgrim is updating our commercial medical policy for the medication Sandostatin, effective for dates of service beginning Oct. 1, 2019.

Read more


Non-Covered Services: Medical Policy Consolidation

To streamline the number of policies that providers need to review and create greater efficiency, Harvard Pilgrim’s Medical Policy Team recently consolidated some existing policies outlining individual non-covered services into a single commercial New Technology Assessment and Non-Covered Services policy.

Read more


Spravato, Zulresso, and Evenity Now Covered for Commercial Plans

Harvard Pilgrim now covers the following newly approved drugs with prior authorization for members of our commercial plans only...

Read more


Acupuncture Benefit Information Added to 271 Eligibility Response

Harvard Pilgrim is happy to announce that we recently expanded the commercial benefit details provided in our 271 eligibility response transactions to include service type 64 (Acupuncture).

Read more



Acrobat Reader *Acrobat Reader required to view PDF files. Download latest version free.

Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Improvements to Claims Processing for Behavioral Health Services

SNF Reimbursement Methodology for Medicare Advantage

CLINICIAN CORNER

Coverage for Lumoxiti and Libtayo

Updates to Commercial Medical Policy for Sandostatin

Non-Covered Services: Medical Policy Consolidation

Spravato, Zulresso, and Evenity Now Covered for Commercial Plans

Coverage of Asceniv Beginning Aug. 1

Members’ Rights and Responsibilities

OFFICE ASSISTANT

Reminder: QMB Members Exempt From Part A/B Cost-Sharing

Reminder: Anatomical Modifiers Are Required When Applicable

Acupuncture Benefit Information Added to 271 Eligibility Response

PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator