As you may know, Harvard Pilgrim Health Care offers a shared administration plan for the Iron Workers District Council of New England/Iron Clad union. 

Effective July 1, 2026 for members of this plan, we’re introducing prior authorization requirements for the following services:

  • Inpatient and outpatient musculoskeletal spine services: managed through an arrangement with our vendor partner Evolent
  • Joint surgeries and procedures: also managed by Evolent
  • Outpatient chemotherapy/oncology services: managed through our oncology medical management program with OncoHealth
  • Home health care services: managed internally by Harvard Pilgrim 

How to request authorization 

Services managed by Evolent: To request authorization for musculoskeletal spine services/joint surgeries and procedures, contact Evolent online at www.radmd.com or by telephone at 800-642-7543. You can find some resources and education materials for these programs — including utilization review matrices with coding — on Evolent’s dedicated webpage for Harvard Pilgrim members.

Services managed by OncoHealth: For outpatient chemotherapy/oncology services, you can request authorization from OncoHealthin one of the following ways:

  • Online — HPHConnect secure provider portal
  • By fax — Fax your request and clinical records to 800-264-6128
  • By phone — Submit requests by calling 888-916-2616 (with any necessary clinical documentation faxed to the number above and appropriate reference number included)

Home health care services: To obtain authorization for medically necessary home health care services, submit your request directly to Harvard Pilgrim by fax at 617-509-1147.

Recognizing members of the Iron Workers plan

As a reminder, identification cards for union members display the Harvard Pilgrim logo, but unlike the ID numbers for most other Harvard Pilgrim plans, the Iron Workers union member ID numbers don’t begin with the HP prefix. They utilize 9-character alphanumeric member ID numbers, which are prefixed with a B.