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FAQs

General

Who is HealthTrio?
HealthTrio is the technology vendor who hosts Harvard Pilgrim’s online service portal, HPHConnect. They work with numerous health plans, including other local payors such as Tufts/Network Health, BMC, and Neighborhood Health Plan.

What if I forgot my user ID and/or password for HPHConnect?
Go to https://www.healthtrioconnect.com and click on "Forgot your password?" or “Forgot your username?” To reset your password, you will need your user ID and access to the email address associated with your account. To retrieve your user ID, you’ll need the first and last name and email address that match your account. Please note: this reset link will only work if your account is not already locked for inactivity (see section below).

How do I reset my account if it’s been locked?
Your account will be locked for inactivity if you do not log into it for 120 days, and you will need to contact HealthTrio at 877-814-9909 to have it reset. They will need to verify your account when you call, so the individual account owner or the account administrator should be the person to contact them. Please note: User accounts with no activity within 365 days will be removed by Harvard Pilgrim.

How often do I need to set a new password?
Your password will expire every 180 days, or approximately 6 months. At that time, the system will prompt you to set a new password and security questions when you log in.

Why does the system take me to a different insurance payor when I log in?
If you have an existing account under HealthTrio, but not for Harvard Pilgrim, you can create a new account registration for Harvard Pilgrim — be sure to click the link that says you have an existing account. This will allow you to enter your existing user ID and password and link your current account to the new Harvard Pilgrim registration (screenshot below). Once your account with us is confirmed, you will then be able to toggle between payors.

Account Setup and Access

I have a HealthTrio account for another insurance payor. How do I gain access to Harvard Pilgrim?
If you have an existing account under HealthTrio, but not for Harvard Pilgrim, you can create a new account registration for Harvard Pilgrim — be sure to click the link that says you have an existing account. This will allow you to enter your existing user ID and password and link your current account to the new Harvard Pilgrim registration (screenshot below). Once your account with us is confirmed, you will then be able to toggle between payors.

 

What if I need help once I start using HPHConnect?
Call Provider eBusiness Services at 800-708-4414 and select option 1, then option 6 whenever you need assistance navigating the system, setting up an account, or performing specific transactions. For help with resetting your account, or to report a system outage, please contact HealthTrio at 877-814-9909.

Can I access HPHConnect if I work for a billing agency?
Yes. In this case, you will need to complete your HPHConnect registration process as the billing agency and NOT as the client(s) you are looking for access to. Once you are enrolled as a billing agency, you can have access to multiple provider clients under one account. The Billing Agencies and Third-Part Representatives page lists the steps for billing agency registration, and the documents we require to complete it.

How long does it take for my account to be set up once I register for HPHConnect?
The maximum turnaround time for processing is 4 business days from when we receive all the necessary registration documents. However, depending on our current volume, the turnaround is often quicker and typically falls within the range of 2-3 business days.

User Roles and Account Management

What do the different user roles in the system mean?
Each HPHConnect user must be assigned a “user role,” which identifies what data/functions that user has access to — for example, whether or not the user can see claims. Definitions of the different user roles are provided in the HPHConnect User Role Information page in Harvard Pilgrim’s Provider Manual.

How can a user get updated to be an account administrator?
The current account administrator can change the user role to Office Manager for the user requesting to be updated. Please see the Adding, Deleting, and Modifying Users of Your HPHConnect Account User Guide for more information. If the current account administrator is no longer with the organization, the user will need to complete and submit the User Role Update Form, which can also be printed from your HPHConnect account under Administration --> Admin Maintenance Tools. The bottom of the form should be signed by a manager or a medical provider other than the user requesting the update.

What is account revalidation?
Account revalidation is a review of user accounts by their main office contact to ensure that access is limited to only those functions needed for the user to accomplish his/her job. The main office contact will perform an annual re-validation of all user accounts attached to the organization’s online account in HPHConnect for providers. It is also a good time to review account users and remove any employees who may no longer be working there. Detailed instructions describing how to complete the account revalidation process are available in this Revalidation of Users of Your HPHConnect Account Revalidation User Guide.

How can I update my account to have access to a new/affiliated practice Tax ID or a missing provider in HPHConnect?
Please complete and submit the HPHConnect for Provider Enrollment Form and indicate that it is an update to an existing account by using the checkbox in Step 1. This form can also be printed from your HPHConnect account under Administration --> Admin Maintenance Tools. As long as the provider you are looking for is credentialed with Harvard Pilgrim, we should be able to add them.

What is the difference between the Office Management and Patient Management Tabs?
The Office Management tab will allow you to perform HPHConnect functions for any Harvard Pilgrim member (eligibility, referral/authorization search, etc.), whereas the Patient Management Tab will allow you to perform transactions specific to one selected member only. To do so, you would first need to load the member by conducting a patient search or selecting them from your patient dropdown list.

Can I submit claims through HPHConnect?
Yes. Single submission for professional medical claims only may be enabled for all users who currently have access to claims data (back office role or higher). This feature is available only for members whose ID number begins with “HP.” For more detailed information about claim submission in HPHConnect, refer to the HPHConnect Professional Claims Submission User Guide.

 
Referral and Authorization
How can I check on a “pending” authorization request?
If an authorization request comes back as “pending,” it typically means that Harvard Pilgrim would need additional information to approve or deny the request. The pend message returned by the system will indicate where the additional information (e.g., clinical data) can be sent to complete the request. To get specific information on exactly what might be needed, you should contact the authorization unit at 800-708-4414 and select option 1, 7, then 3 for referral/auth.

I can’t find a referral or authorization that I know is in the system. What might be wrong?
There could be several reasons you are not able to locate a referral or authorization. These are the most common explanations:


  • In many cases, it may have to do with how you are performing the search. If you are searching by the request number, make sure you are using capital letters (it is case sensitive). If you are searching by the member’s ID number, make sure you have clicked the circle to search by member ID and adjust the date range of your search to include the start date of the referral or authorization request.
  • You may need to update the tax ID number (TIN) that you have access to. There may have been payee numbers added to your TIN or you may have obtained a new TIN since your account was originally set up, which the referral may have been processed under. Please see instructions above for requesting an account update.
  • The provider record the referral was processed under may not be part of your practice (for example, if you are with Atrius Health and the provider record entered on the referral is affiliated with Lahey). In this case, the referral would need to be updated to include a provider record that is part of your practice for you to see it in HPHConnect. This can be accomplished by contacting our provider call center at 800-708-4414 and selecting option 1, then 7, then 3 for referral/authorization.
Technical Requirements

You will need an internet connection through an Internet service provider (ISP)), a standard web browser and Adobe Acrobat Reader® (available as a free download from the Adobe Web site). See the HPHConnect Technical Requirements page in Harvard Pilgrim’s Provider Manual for more information.

Security

Can I be sure that the information going over the internet is kept secure and confidential?
Yes. HPHConnect utilizes the following:


  • Independent 3rd-party vendors to perform security checks on Harvard Pilgrim web services, on average twice per year
  • "State-of-the-art" authentication and authorization software to manage and enforce access controls
  • Password standards that are robust and meet or exceed industry password standards
  • 128-bit SSL encryption which is the same standard the financial industry uses for home banking services
  • A sophisticated intrusion detection system performs real-time monitoring, notification of events, and immediate response to any suspicious activity.

Can another provider see my claims?
No. A provider can only see claims related to their individual practice or physician group. Harvard Pilgrim will work with you to provide the access you need while ensuring confidentiality for our providers and members.

If I refer a patient to a specialist, will I be able to see the claim that the specialist submits?
No, you will not be able to view claims for providers outside your individual practice or physician group. Our office is also a Harvard Pilgrim employer group.

Why are there two security agreements; how does one differ from the other?
The Privacy and Security Agreement is a legal document signed by a representative of Harvard Pilgrim and the person in the provider organization responsible for signing contractual agreements (e.g., provider, office manager, Medical Director, CFO, etc.). The purpose of this agreement is to protect the confidentiality of Harvard Pilgrim member information. The User Agreement confirms that the individual users understand and will protect the confidentiality of the Harvard Pilgrim member information obtained.


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