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

October 2016

Assisting our Nurse Case Managers with Requests for Information

Harvard Pilgrim operates robust disease management and care coordination programs, in which our nurse case managers work collaboratively with members, their caregivers, and health care providers to provide patient education, assist patients in managing their condition, and ensure the most appropriate plan of care is being followed.
From time to time, our nurse case managers may contact providers seeking assistance from you or your office staff. In many cases, our nurse case managers need help to ensure that we have the most up-to-date contact information — such as a home phone number, cell phone number, or email address — for the member. We may also be seeking clinical information. Harvard Pilgrim appreciates your cooperation in providing us with this information for care management purposes.

Rest assured that Health Insurance Portability and Accountability Act (HIPAA) privacy laws allow you as a covered entity to share this information with Harvard Pilgrim, and that Harvard Pilgrim will protect this information appropriately.

“Sometimes office staff will ask our nurse case managers about whether privacy laws are an impediment to sharing this information,” explained Christopher Walsh, Harvard Pilgrim’s Privacy Officer. “We want to assure them that this exchange of information between our contracted providers and Harvard Pilgrim is allowable under HIPAA. Harvard Pilgrim will be using this information to provide care management services aimed at improving the patient’s compliance with their physician’s treatment plan and enhancing their health and well-being.”

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Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator