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

December 2015

Improvements in Provider Claims Reporting Tools

Harvard Pilgrim is updating our Provider Claims Reporting toolset to increase efficiency and improve user experience. If you have accessed these reports in the past, you’ll notice their new look, starting in early January.

The Provider Claims Reporting tool, found in HPHConnect, helps providers monitor and manage claims activity at their practices. It allows the provider to view 14 months of claims-related information, including generating reports showing claims status, payees, and check paid dates; EDI transaction summary and provider demographic reports; and provider analytics dashboards. While the data reflected in the report remains the same, the selection and running of the reports is moving to a MicroStrategy based user interface, which employs menus rather than checkboxes for users inputting information.
Whether you have accessed these reports in the past or are new to them, you will need a valid HPHConnect account and the appropriate MicroStrategy license (available through HPHConnect) to view them in 2016. Instructions for registering for HPHConnect are available on our provider website.

Harvard Pilgrim’s Guide for Managing Office Claims Activity offers helpful information on using this toolset and is available on our provider website.

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Network Matters Archives

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Harvard Pilgrim Welcomes New Employer Accounts and Products for 2016


PCSK9 Inhibitors: Prior Authorizations and Innovative Contract for Repatha

Pharmacy Updates: 90-day Supplies at Retail and Controlled Substance Limitations

Reminder: Referral Procedure Change for Massachusetts Providers

Reminder: Prior Authorizations for Medicare Advantage via NIA

Administration of Zostavax by Pharmacists

CMS Requirement: Enrolling as a Participating Medicare Provider

Substance Abuse Screening and Referral for Treatment

Reminder: Mandate on Inpatient Care Related to Breast Cancer


Professional Claim Submission Available on HPHConnect

Improvements in Provider Claims Reporting Tools

Urgent Care Network Requirements


Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator