HPHConnect

HPHConnect — Harvard Pilgrim’s highly acclaimed Web-based transaction service — gives you access to health plan information and self-service transactions for your Harvard Pilgrim patients, 24/7. HPHConnect is HIPAA-compliant and it’s free. If you don’t currently use HPHConnect, we encourage you to REGISTER TODAY!

 

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For further questions about HPHConnect: 

Perform the following transactions online:
  • Submit claim batch files (HIPAA 837 Format)
  • Single claims direct data submission for professional claims
  • Verify patient eligibility
  • Find the status of a claim
  • Send/receive specialty referrals
  • Provide notification
  • Submit/receive authorization
  • View a patient’s personal health record (PHR)
Access news, information, and reports:
  • Provider Manual, Insights and Updates for Providers, and Provider Directory
  • Code auditing reference tool (CMS-1500 Claims)
  • Drug formulary and pharmacy programs
  • Diagnosis, procedure, and revenue codes
  • PCP membership reports
  • Claims reports
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User guides

Our user guides offer step-by-step guidance on a variety of common transactions, including account maintenance, performing referral and authorization transactions, downloading reports, and more. View the guides

Handy FAQ

Have a question about HPHConnect? We’re here to help! Our in-depth FAQ covers common questions about account set up and access, user roles, account management, referral and authorization, security, and more. Read the FAQ

InterQual Medical Review Tip Sheet