Join the Harvard Pilgrim Health Care network

Founded by doctors over 50 years ago, Harvard Pilgrim Health Care combined with Tufts Health Plan in 2021 to form Point32Health, a leading not-for-profit health organization. Become a participating provider today, and together we can improve outcomes and the value of health care, through true collaboration in tackling today’s health care challenges. 

To join our network, please complete and submit the following materials to Harvard Pilgrim’s Provider Processing Center for review. For status inquiries on your application please call the Provider Service Center at 1-800-708-4414.

Submit your application documents by email to: [email protected]

 

Medical Professional Providers

For providers such as MDs, DOs, DPMs and oral surgeons. If you participate in a Physician Organization (such as an IPA or PHO), prior to completing the above paperwork, contact the Provider Unit or Contracting administrator of your organization to discuss next steps.  

 

Ancillary Providers

Includes Ambulance, ASC, DME, Home Care, Infusion Centers, Labs, Radiology, SNFs, and Urgent Care

 

Behavioral Health

(Please note that, consistent with state requirements, Rhode Island providers requesting to join our commercial network must also become participating providers in our Rhode Island Medicaid network for the Tufts Health RITogether product.)

Understanding contracting and enrollment

Refer to our “Becoming a network provider” tip sheet to learn about contracting, credentialing, and enrollment, and maintaining your CAQH profile. View the tip sheet

 

Start with our Welcome Flyer

Once you are a participating provider, our Welcome Flyer will guide you through getting started with us, including registering for our secure portals, EFT, and our provider newsletter. View our Welcome Flyer

Credentialing is your next step 

Credentialing is an important step in being able to provide care to our members. Refer to the credentialing information below and begin with CAQH ProView. Get started at CAQH ProView

  • We will return a contract to you for review. The contract should be reviewed, signed and sent back to us to initiate credentialing.
  • Once the contract is finalized and you are approved as a participating provider, we will send you a welcome letter that includes your network participation effective date and useful resources.
  • Generally, credentialing and contracting can take 1-2 months. However, that time frame is extended if the application is incomplete.
  • Point32Health credentials affiliated providers when they join the network. Clinicians cannot provide services for members until the credentialing committee approves them for network participation.
  • Credentialing occurs once the provider has a signed agreement with the Plan. The Credentialing team cannot proces the application until all required materials are received. You will be notified by email if the application cannot be processed due to incomplete information.
  • Applicant requesting an initial affiliation with Point32Health will be credentialed through the HCAS process, utilizing CAQH’s ProView system, a central repository for credentialing information. Data from CAQH ProView will only be transmitted to plans with which clinicians are already contracted or are in the process of contracting. For more information about HCAS and its credentialing process, go to www.hcasma.org.
  • Get started by visiting CAQH ProView.
  • Once you are a participating provider, please review this Welcome Flyer to guide you through getting started with us. It will get you started with registering for our secure portals, signing up for our monthly electronic newsletter, registering for electronic funds transfer and more.
  • We also encourage you to review our Harvard Pilgrim Health Care Commercial Provider Manual and our product page.