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

April 2014

Notifying Harvard Pilgrim of Provider Changes

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).

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The Affordable Care Act and Risk Adjustment


Spine Management and Prior Authorization

Medical Policy for Allergy Immunotherapy

Medical Policy for IgG Allergy Testing

Tier Change for Omnitrope and Tev-Tropin

Zostavax Now Available at Retail Pharmacies

P&T Committee Updates

Specialty Pharmacy Updates

Routine Screening for PTSD


Notifying Harvard Pilgrim of Provider Changes

CMS 1500 (08/05) Form Rejected After June 15


Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator