When changes occur in your practice — for example a change in address, addition or change in tax identification number (TIN), adding an LCU affiliation, etc — it’s important to provide Harvard Pilgrim with advance written notice in accordance with our Changing Provider Enrollment Information Policy. The same procedures apply whether participation is with our commercial products or Medicare and Medicaid plans.
The Changing Provider Enrollment Information policy, found in Harvard Pilgrim’s Provider Manual, outlines which changes require notification and how best to notify Harvard Pilgrim of such changes.
We recommend that you use the Harvard Pilgrim Provider Change Form for this purpose. However, Harvard Pilgrim accepts other notices, too. If you are participating in, or wish to participate in, Harvard Pilgrim’s Medicare Advantage StrideSM product and elect to use another form, please include your Medicare ID, NPI, TIN, and LCU name (if applicable) to confirm that you are eligible and interested in participating in Medicare Advantage Stride (HMO).