Have you visited our new behavioral health webpage yet? If not, we encourage you to do so today. It’s your one-stop shop for information to support you and your practice, including:
- Policies and forms — You’ll find links to payment policies, medical necessity guidelines, forms, and pharmacy information.
- Quick Reference Guide — If you are new to the Harvard Pilgrim Health Care network our handy 2-page Quick Reference Guide can guide you on recognizing members and verifying eligibility, submitting claims, requesting authorizations, accessing e-tools, and more.
- Portal and electronic tools — You can quickly access our secure provider portals from this page and access user guides.
- Recommended articles —You’ll find behavioral-health-specific articles from this provider newsletter highlighted on the page, too.
New provider training video and ongoing training sessions
We developed a new, short video to guide providers who are new to our Harvard Pilgrim network in navigating our online provider portal, HPHConnect, for electronic claims submission. This video walks you through submitting a claim on HPHConnect, step-by-step. Visit the training video page for more helpful videos.
We’re also continuing to offer online, interactive trainings tailored for behavioral health providers. Be sure to check out our Behavioral Health Training page for all the latest offerings and to register for a session.
Reminders on BH insourcing
As a reminder, we have now integrated and insourced our behavioral health program. This change impacts Harvard Pilgrim Health Care commercial members only, and the transition from Optum/United Behavioral Health services to this new insourced model occurred on Nov. 1, 2023.
- For these members, providers in our service area should work directly with Harvard Pilgrim for behavioral health services, including obtaining prior authorizations, submitting claims, coordinating with care managers, and contacting the Harvard Pilgrim Provider Service Center (800-708-4414) with questions. Refer to the Quick Reference Guide for details on where to submit claims, how to request authorization, and more.
- Until further notice, as a transitionary measure, providers who participate in the UnitedHealthcare network will continue to be eligible to provide services to Harvard Pilgrim commercial members and will be considered in-network providers. As noted above, Harvard Pilgrim Health Care policies apply as of Nov. 1, 2023, and claims should be submitted directly to Harvard Pilgrim Health Care. Providers contracted with Harvard Pilgrim will receive our rates, while non-contracted providers who are part of the UnitedHealthcare network will be paid at UnitedHealthcare rates.
- Optum will continue to provide behavioral health services for Harvard Pilgrim Health Care’s Medicare Advantage StrideSM (HMO)/(HMO-POS) plan in New Hampshire through Dec. 31, 2024. For StrideSM members, please continue to work directly with Optum as you do today.
The best way to ensure you can continue to care for your Harvard Pilgrim commercial members is to contract directly with Harvard Pilgrim Health Care. To contract with Harvard Pilgrim Health Care, contact AHCBehavioralHealth@point32health.org.
Director, Provider Relations & Communications
Senior Manager, Provider Communications
Joseph O’Riordan, Susan Panos, Ryan Francis, Stephen Wong,