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

December 2013

Reminder: Resources Available for StrideSM (HMO) Plans


Next month, Harvard Pilgrim’s new Medicare Advantage StrideSM (HMO) and StrideSM of New Hampshire (HMO) plans take effect, and Harvard Pilgrim has a variety of resources to help providers who are participating in the Stride network become more familiar with these products and accompanying procedures.

Our Medicare Advantage Stride (HMO) website features:

  • An overview of the Stride (HMO) plans
  • A quick reference guide for Stride (HMO) providers — This handy 2-page flyer can help you navigate common processes. It explains how to recognize members and verify eligibility, request authorizations, submit claims, and request a claims adjustment or appeal claims. It also includes key contact information.
  • A video presentation for providers — This training presentation walks providers through plan design and benefits, and includes an overview of policies and procedures (member eligibility, claims, appeals, credentialing, etc) and using the Medicare Advantage Provider Portal.
  • The Medicare Advantage Provider Manual — This reference for providers participating in the Stride (HMO) plans includes detailed information on coverage, provider roles and responsibilities, credentialing and recredentialing, claims and billing, reimbursement methodology, and member rights and responsibilities.
  • Information about the Medicare Advantage Provider Portal — This portal supports a variety of online transactions, such as verifying member eligibility and cost sharing, making referrals, and submitting and tracking claims. Visit the Stride (HMO) page to learn about registering for this tool.

If you have any other questions about these plans, please contact the Medicare Advantage Provider Service Center at 888-609-0692.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator