Harvard Pilgrim offers guidance, information, and resources to help ensure you receive timely, accurate reimbursement for the services you provide to our members. On this page you’ll find reference materials to guide you and your office staff in coding accurately for services you administer, understanding Harvard Pilgrim payment policies and procedures, submitting claims and appeals, and more.
We recommend electronic billing for the fastest reimbursement because it results in fewer errors, more control over data accuracy, improved cash flow, and lower operating costs — and our web-based transaction service HPHConnect makes that especially simple!
Review our commercial Payment Policies for a variety of services.
Information on claims submission and resources for paper and electronic claims.
Refer to our commercial appeals policies and information on filing limits.
Access our library of forms for commercial plans.
Sign up for electronic funds transfer for convenient reimbursement.
Information for out-of-network provider payment disputes related to claims that qualify for No Surprise Act protections.
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.
Provider Service Center (commercial):
800-708-4414
Care Management
888-888-4742, x 31035