What network does Harvard Pilgrim use?
Network ChoiceSM CT PPO — Harvard Pilgrim’s Network Choice CT PPO is a tiered Connecticut sold plan. Hospitals and physician groups are designated one of two tiers.
What are Harvard Pilgrim flex providers?
A Flex Provider is a Plan Provider who provides certain outpatient services with lower Member Cost Sharing.
How do I submit a claim to Harvard Pilgrim?
Call 1-888-333-4742 (TTY: 711). Harvard Pilgrim Health Care and its affiliates as noted below (“HPHC”) comply with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
What is the filing limit for Harvard Pilgrim?
90 days
Standard Filing Limit • 90 days from the date of service. Members may not be billed for services submitted after the filing limit.
What is Harvard Pilgrim stride?
Harvard Pilgrim is an HMO/HMO-POS plan with a Medicare contract. Enrollment in StrideSM (HMO) depends on contract renewal.
Is Tufts part of Harvard Pilgrim?
Tufts Health Plan and Harvard Pilgrim Health Care announced an “intentionally modern” name for their newly combined insurance organization. Tufts Health Plan and Harvard Pilgrim Health Care announced that their newly combined insurer will be called Point32Health.
When did Harvard switch to Blue Cross Blue Shield?
January 2020
Beginning in January 2020, Blue Cross Blue Shield of MA will replace Harvard Pilgrim Health Care as one of the two health insurer choices available to all University employees. Every health plan offered in 2019 under Harvard Pilgrim will be available as a comparable plan under Blue Cross Blue Shield in 2020.
Does Harvard Pilgrim pay for consult codes?
As of dates of service on or after November 1, 2021 Harvard Pilgrim will no longer reimburse consultation services.
Does Harvard Pilgrim stride require referrals?
Evidence of referrals for specialty care is required for members enrolled in Harvard Pilgrim’s Stride (HMO/HMO-POS) plans. Members may self-refer to in-network providers for routine eye exams, routine OB/GYN services, Medicare Preventive Services, and emergency care.
Who bought Harvard Pilgrim?
Tufts Health Plan and Harvard Pilgrim are now one organization. We are excited and optimistic about our future, and we believe our new organization will bring more value to you and the communities we serve.