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

2020 Network Matters archives

July
  • Guidance from Massachusetts Governor on Phase 2 Re-Opening
  • Harvard Pilgrim Providing Aid to Providers, Members and Employers
  • Outpatient Oncology Prior Authorization: Effective on Sept. 1
  • Medical Drug Authorization: Dose and Frequency for Sept. 1
  • Medicare Advantage: Dosage and Frequency Limits
  • Genetic Counseling No Longer Required Prior to Genetic Testing
  • InterQual Criteria for Bariatric Surgery
  • Transgender Health Services Commercial Medical Policy Updates
  • Medicare Advantage: Prior Authorization Updates
  • Stride Varicose Veins Procedures Medical Policy Updates
  • Medicare Advantage: Chest Wall Deformities Reconstructive Policy
  • Medicare Advantage: Billing for Home Infusion Therapy Services
  • Help Us Keep Directory Information Up to Date
  • Xtampza ER Commercial Coverage Update
  • Pharmacy and Therapeutics Committee Meeting Update
  • Specialty Pharmacy Program Updates
  • Reminder: Correct Coding for Principal Procedure Codes
June
  • COVID-19 Resources Updated in May
  • GIC Product Updates Effective July 1
  • New Access America Value Product
  • HPHC-CT Plans Name Change on July 1
  • Genetic Testing Code Updates
  • Updates to NIA’s Musculoskeletal Criteria
  • Cosmetic and Reconstructive Eye Procedures Medical Policy Updates
  • New Stride Medication Prior Authorizations
  • Updates to Medicare Advantage Remicade Medical Policy
  • 2020 Home Care Seasonal Flu Vaccine Fee Schedule
  • Durable Medical Equipment Payment Policy Updates
  • Payment Policy Update: Injectable and Implantable Outpatient Drugs
  • Payment Policy Update: Billing Requirements for Outpatient Revenue Codes
May
  • Latest Information for Providers: COVID-19 Resources Updated
  • Drive-Through Testing Site for COVID-19
  • Home Infusions for Eligible Patients to Promote Social Distancing
  • Updates to Cardiovascular Disease Risk Tests Medical Policy
  • InterQual Criteria for Oral Devices for Obstructive Sleep Apnea
  • Prior Authorization Now Required for HCPCS Code J0642
April
  • COVID-19: Provider Support and Resources
  • Oncology Authorization Program Delayed
  • New Look for Our Online Provider Directory
  • Medicare Advantage: Referral Procedure Change for ME and NH
  • Reminder: New PCP Change Functionality in Portal
  • InterQual Criteria for Cholecystectomy
  • Sleep-Related Supply Code Updates
  • Pharmacy and Therapeutics Committee Meeting Update
  • Specialty Pharmacy Program Updates
  • Complex Case Management Services
  • Disease Management Programs Reinforce Physician Treatment Plans
  • Help Us Keep Directory Information Up to Date
  • Billing Update: Surgical Pathology for Prostate Needle Biopsy
  • Payment Policy Updates: Advanced Practice Clinicians
March
  • Coming in March: PCP Change Functionality in Portal
  • Outpatient Oncology Prior Authorization: Effective for Medicare Advantage on May 11
  • Network Meeting: Sign Up for our Portland ME Event (POSTPONED)
  • Harvard Pilgrim’s Ethics Program and Ethics Advisory Group Discussions
  • Updates to Commercial Capsule Endoscopy Medical Policy
  • Advance Care Planning Coverage (99497 & 99498)
  • Inappropriate Use of Foot Baths in the Medicare Population
  • Provider Directory Updates: Continuing CAQH DirectAssure® Rollout
February
  • Coming Soon: PCP Change Functionality in Portal
  • 2020 Physician Group Honor Roll Announced
  • InterQual Criteria for Outpatient Pulmonary Rehab
  • Medicare Transgender Health Services Updates for April 1
  • NIA 2020 Code Updates
  • Non-Opioid Pain Management Coverage and Resources
  • Members’ Rights and Responsibilities
  • 2020 Fee Schedule Updates
  • Review NPI Data Using National Plan and Provider Enumeration System

January

  • Submitting Claims for Members of Certain HPI Accounts
  • HEDIS 2020 Coming Soon: Your Cooperation is Crucial
  • InterQual Criteria for Cryotherapy for Prostate Cancer
  • Prior Authorizations for Xiaflex and Miacalcin
  • Medicare Advantage: Diabetes Updates for March 1
  • Updates to Yervoy Medicare Advantage Medical Policy
  • Pharmacy and Therapeutics Committee Meeting Update
  • Palliative Care and the MA Coalition for Serious Illness Care
  • Consultation Service for Treatment of Addiction and Pain
  • Connecticut Providers: Termination Requirements

Network Matters Archives

2019

2018