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

December 2015

Urgent Care Network Requirements

As a reminder, Harvard Pilgrim requires that every individual urgent care location go through our facility credentialing process prior to providing care to our members. For a new urgent care location to be added to an existing contract, it must be credentialed according to Harvard Pilgrim standards, and the contract must be amended to include all locations associated with that urgent care tax identification number and National Provider Identifier (NPI).

Urgent care credentialing and procedural requirements

To participate in our urgent care network, all urgent care providers must:

  • Have a direct agreement with Harvard Pilgrim
  • Meet our facility credentialing standards
  • Meet all state and federal licensing requirements
  • Have a unique urgent care group NPI
  • Submit claims in accordance with our Urgent Care Payment Policy

Refer to the February Network Matters article and the Facility Credentialing and Recredentialing policy in Harvard Pilgrim’s online Provider Manual for further information regarding the services providers in our urgent care network are contracted to provide, network participation requirements for Urgent Care & Walk-In Providers, and payment policies for urgent care providers.

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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