Welcome Providers
Resources and information for providers and office staff
Welcome Providers
Resources and information for providers and office staff
Please note
As banks will be closed in observance of Independence Day on Friday, July 4, 2025, electronic fund transfer (EFT) payments will be delayed until Monday, July 7, 2025.
Policies, Manuals & Forms
Behavioral health
Training
News Insights and Updates for Providers - July 2025
Point32Health Site of Service Payment Policy
Our new integrated Site of Service Policy, applicable for all products, includes an update to our site of service logic and reimbursement methodology for services rendered via telehealth/telemedicine.
Coverage changes for Stelara and biosimilars
There will be upcoming coverage changes related to Stelara and biosimilars, and we recommend prescribers write a new prescription to aid the transition.
Prior authorization and claims denials for Maine
Claims for services for Maine members of Harvard Pilgrim fully insured Commercial plans that do not have the required prior authorization are subject to a penalty fee.
Electronic Tools and Resources
Our electronic transaction capabilities make doing business with us quick and efficient. Explore our electronic services and learn about our secure portal capabilities for:
Join the network
We invite you to join us in ensuring that our communities have access to high-quality, equitable health care by becoming a participating provider.
Our plans
Learn more about the diverse range of health plans we offer under our legacy brands, Harvard Pilgrim Health Care and Tufts Health Plan.
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Short video: Checking referrals, notifications, and authorizations in HPHConnect
We’ll show you how to use the Harvard Pilgrim Health Care secure portal, HPHConnect, to check the status of a referral, notification, or authorizaton request. The video shares step-by-step instructions and time-saving tips.