Insights and Updates for Providers

November 2024
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Highlights

Reminder: StrideSM Medicare Advantage to be discontinued

As a reminder, we will no longer offer the Harvard Pilgrim Stride Medicare Advantage plan as of Jan. 1, 2025.

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Pharmacy coverage changes

The following changes to Point32Health’s Pharmacy program take effect on Jan. 1, 2025, including prior authorization, drug status, and formulary updates for various products.

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Observation Stay Payment Policy and process change

Effective Jan. 1, 2025, Point32Health is making a change to our review process for short inpatient stays and observation services.

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Additional Information

Join the Network

Learn more about participating in Harvard Pilgrim’s exceptional provider network

Network information

Our Products

Familiarize yourself with Harvard Pilgrim’s wide range of plans

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E-Business

Our electronic transaction capabilities make doing business with us quick and efficient

E-tools

COVID-19 Provider Resources

You’ll find the latest provider updates on COVID-19 related policies, coverage, and reimbursement here.

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Provider Training and Events

Learn about upcoming webinars and office manager meetings, watch 3-minute video training sessions, and access training guides and resources. Plus share your feedback to help us create new events and tools geared to your needs.

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Vendor Prior Authorization Programs

Reference information on our vendor partners who conduct utilization management for certain services.

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