Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

June 2014

Credentialing of Urgent Care Centers


Effective August 15, 2014, Harvard Pilgrim will be modifying our credentialing  requirements for contracted, free-standing urgent care centers. In July, we will mail a letter and Request for Information (RFI) to urgent care centers in our network, explaining the credentialing process. Completed RFIs should be returned within two weeks. As part of the credentialing process, Harvard Pilgrim’s facility credentialing review team may conduct a site visit.

Harvard Pilgrim’s Facility Credentialing Committee will review the information provided to determine whether the urgent care center meets Harvard Pilgrim’s standards, and will notify the facility in writing once a determination is made. For more detailed information on the credentialing process, please refer to the Facility Credentialing and Recredentialing policy in our online Provider Manual.

Additionally, contracted urgent care facilities will be responsible for ensuring that their providers meet Harvard Pilgrim’s credentialing standards. The urgent care facility must have credentialing policies in place that monitor and review their clinicians’ knowledge, training, and licensure. These reviews should include approval by the practice/facility medical director and be conducted on a periodic basis in accordance with state law. For more information on credentialing standards for urgent care clinicians, please review the Urgent Care and Walk-In Providers policy in our Provider Manual.

Email this article to a colleague   

Receive Network Matters by e-mail

Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Trainings Available for Connecticut Providers

Credentialing of Urgent Care Centers

GIC Product Updates Effective July 1

CLINICIAN CORNER

Prior Authorization Requests for Spine Procedures Accepted Beginning June 23

Substance Abuse and Depression in Primary Care

Physical and Occupational Therapy: Payment for Initial Evaluations

OFFICE ASSISTANT

CMS 1500 (08/05) Form No Longer Accepted

Reminders for Better Claims Processing

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