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Find helpful administrative and clinical resources that can assist you with a wide range of topics related to key contacts, e-transactions/e-services, payment policies, products, and more.

Administrative

A Guide to Harvard Pilgrim Member ID Cards
(i.e., by plan)
 
A Commercial Plans Guide to Provider Services
(i.e., channels/plans/e-transactions)

A National Plans Guide to Provider Services
(i.e., channels/plans/e-transactions)
 
A Senior Plans Guide to Provider Services
(i.e., channels/plans/e-transactions)

Code Auditing Reference Tool (CMS - 1500 Claims)
(i.e., HPHConnect Web-based application)
  
Keys to Success 
(i.e., administrative best practices; resources)

Payment Policies
(i.e., payment methodology (A-Z))

Clinical

Behavioral Health Care Options
(i.e., resources)

NIA Radiology Management Program
(i.e., FAQS, Checklist)

 
Key Contacts
Provider Service Center
(800) 708-4414
Referral & Authorization Requests
(800) 708-4414
Behavioral Health Care Resources
(888) 777-4742
Care Management
(888) 888-4742,
Ext. 31035
EDI Team
(800) 708-4414 (Option 1; then press 3)
HPHConnect
(800) 708-4414
(Option 1; then
press 6)
Provider Relations Consultants (PRC)
  • CT
    (877) 594-7190
  • MA/RI
    (888) 888-4742
  • ME
    (888) 476-2463
  • NH
    (800) 544-9759

Who's my Provider Relations Consultant?
Key Contacts Directory (Download)