Back to Insights and Updates for ProvidersJune 2023

NIA vendor program code updates

Harvard Pilgrim and Tufts Commercial  |  Harvard Pilgrim Stride (HMO) Medicare Advantage  |  Tufts Health Plan Commercial  |  Tufts Health Public Plans

In the April issue of Insights and Updates for Providers, Point32Health announced a number of changes expected to take effect June 1, 2023 in relation to the medical necessity review and prior authorization program that National Imaging Associates, Inc. (NIA) oversees on our behalf for certain procedures.

While the updates announced for our Tufts Health Plan commercial and Tufts Health Public Plans products are now in effect, the changes we announced for Harvard Pilgrim commercial and Harvard Pilgrim Health Care StrideSM (HMO)(HMO-POS) have been delayed as a result of the system outage we are experiencing. (For specific code update details, refer to the chart included in the original article titled “NIA vendor program code updates,” which begins on Page 13 of this PDF of the April newsletter issue.)

We do not yet know when our systems will allow us to configure the changes related to Harvard Pilgrim products, but we will issue an updated communication in a future issue of the newsletter to keep you apprised in advance of the new effective date for those updates.

Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

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