Billing and Reimbursement

Payment Policies

Review our commercial Payment Policies for a variety of services.

View Provider Manual section

Claims Information and Policies

Information on claims submission and resources for paper and electronic claims.

View Provider Manual section

Appeals Information

Refer to our commercial appeals policies and information on filing limits.

View Provider Manual section

Forms

Access our library of forms for commercial plans.

View forms

Electronic Payment

Sign up for electronic funds transfer for convenient reimbursement.

View Electronic Tools

Account Reconciliation

Refer to commercial policies on account reconciliation, audit, negative balance, retractions, and refunds.

View Provider Manual section

HPHConnect

HPHConnect is Harvard Pilgrim’s highly acclaimed Web-based transaction service for our commercial plans. It’s free, available 24/7, and is HIPAA-compliant. Here you can submit batch claim files, verify patient eligibility, send/receive specialty referrals, submit authorization requests, and more.

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Key Contacts

Provider Service Center (commercial):
800-708-4414

Care Management
888-888-4742, x 31035

E-Services/EDI-Direct:
800-708-4414 (Option 1; then 3)
E-mail: EDI_Team@HarvardPilgrim.org

E-Services/HPHConnect Service Center:
800-708-4414 (Option 1; then 6)
Email: provider_ebusiness_services@harvardpilgrim.org