Harvard Pilgrim Health Care Home
  Learn more.
  Sign up for HPHConnect.
Medical Management
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Press Releases
Office Support
Provider Manual
Research & Teaching
Resources & Links
Print    Text Size

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

January 2010

Eligibility inquiry and response now available for HPI-administered products

Eligibility inquiry and response are now available to electronic data interchange (EDI) users for Harvard Pilgrim products administered through Health Plans, Inc. (HPI).

The 271 response will include covered services, non-covered services, and services with limitations, copayments, deductibles, coinsurance, and out-of-pocket maximums. Remaining deductible and out-of-pocket maximums are not yet available, but will be in a future release.

For transactions related to plans administered through HPI, providers should call HPI directly at (800) 532-7575 for immediate responses to their questions about the content of the eligibility response.

Technical submission questions will continue to be directed to Harvard Pilgrim. HPI member eligibility and benefits will be available only though the 270/271 response (and applications using the 270/271), and will not be available through HPHConnect.

If you would like to test these modifications, and you require test members, please call Nick Stano at (617) 509-5717 or e-mail Nicholas_Stano@harvardpilgrim.org. Please contact Provider eBusiness Services at provider_ebusiness_services@harvardpilgrim.org or (800) 708-4414 (select option 1, and then option 6 from the main menu) with any other questions. 

Join our mailing list!
Enter your e-mail:

Download printer-friendly version


Fee schedule updates

Annual events honor excellence in care

New Hampshire Core Coverage HMO

Starting next month: Changes to cost sharing for GIC Independence Plan members

Provider Analytics provides control of accounts receivable

Introducing: well, then

Reminder: HPHConnect for Providers—policies and procedures

Eligibility inquiry and response now available for HPI-administered products


Radiology Management Program update

Assessing suicide risk

Reminder: First Seniority Freedom drug formulary

P&T Committee update


Claims editing software update

Policy update: global surgical services 

Policy update: multiple E&M services

Provider Manual updates


View all upcoming Provider Trainings

Network Matters Archives

Give us your feedback