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

May 2015

Reminder: Ensure That Claims Contain Valid Codes


Harvard Pilgrim has been upgrading its claims systems, and it’s more important than ever to ensure that any claims you submit, whether electronic or paper, contain valid code sets.

Before submitting claims, please check to make certain that you are using published industry standard codes for the following:

  • Diagnosis and POA (with diagnosis code reported at the highest level of specificity)
  • Revenue, CPT, modifier, HCPCS, and ICD procedure
  • Place of service (professional)
  • Source and type of admission
  • Discharge status
  • Claim frequency
  • Condition, occurrence, value, and patient reason for visit
  • Facility type

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

New Updates Coming to HPHConnect

Harvard Pilgrim’s Preparations for ICD-10 Transition

CLINICIAN CORNER

Improvement in Coordination of Benefits Process

Coverage for Artificial Cervical Disc Replacement with Prior Authorization

Two New Medical Policies Now Available

Complex Case Management Services

Disease Management Programs that Reinforce Physician Treatment Plans

Specialty Pharmacy Program Updates

Reminder of Member Cost Sharing Waiver Policies

Collaboration among PCPs and Behavioral Health Providers

OFFICE ASSISTANT

2015 Update of the Home Care Seasonal Flu Vaccine Fee Schedule

Reminder: Ensure That Claims Contain Valid Codes

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator