Insights and Updates for Providers

January 2025
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Highlights

Use our secure HPHConnect portal for speedy self-service

We encourage providers and office staff to use our secure HPHConnect portal to conduct a variety of self-service transactions for Harvard Pilgrim Health Care Commercial members.

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Continued stay and inpatient level of care reviews

We’re sharing a reminder regarding continued stay reviews for DRG case rate admissions, and an update to our level of care review process for elective inpatient surgical procedures.

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2025 Physician Group Honor Roll announced

Consistent with new Maine regulation, we will no longer deny claims from network providers for failure to obtain prior authorization.

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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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