How to best reach contacts via email
To ensure your emails reach us, please use the @point32health.org domain.
To ensure your emails reach us, please use the @point32health.org domain.
We’re offering several interactive webinars throughout the month of January.
Review and update provider information at least quarterly to avoid directory suppression.
Read more to review updates to Point32Health Medical Necessity Guidelines.
New and updated Point32Health medical drug prior authorization programs.
Have you visited our new behavioral health webpage yet? If not, we encourage you to do so today.
Learn more about the importance of responding to HEDIS medical record requests.
Join an upcoming provider training in December.
Point32Health maintains a number of clinical practice guidelines, which you can now find on the Clinical Practice Guidelines section of our provider website.
Supporting providers to combat preventable emergency department visits.
Medical necessity guideline updates.
New and updated medical drug prior authorization programs.
We’ve insourced behavioral health and launched a new behavioral health webpage.
Claims consultation event coming to Connecticut on Nov. 8.
Upcoming provider trainings: referral and authorization, behavioral health, and more!
We’ve developed new HEDIS® tip sheets for your practice.
Reminders for providers regarding our COVID-19 coverage.
2024 CPT and HCPCS codes accepted for Jan. 1, 2024.
Introducing new integrated Point32Health payment policies.
New and updated Medical Necessity Guidelines for Jan. 1, 2024.
Access to care policies for Tufts Health Plan and Harvard Pilgrim.
Claims consultation events coming in RI, MA, NH, CT, and ME.
Point32Health has appointed Glenn Pomerantz, MD, JD as our new Chief Medical Officer.
Point32Health has developed new tip sheets for three HEDIS measures.
Reminder: it’s important to offer children routine behavioral health screening.
Review and verify the accuracy of demographic data at least quarterly.
Learn more about vaccines and screenings recommended annually for patients between ages 12-21.
Read more for information on updates to Point32Health’s Pharmacy prior authorization programs.
Review changes and updates to Point32Health’s Medical Necessity Guidelines (MNGs), information about newly developed MNGs, and more.
Review changes and updates to Point32Health’s medical drug program.
Point32Health has developed some integrated Point32Health Payment Policies.
Read about federal changes regarding prescribing buprenorphine and training requirements.
After the resounding success of the July claims consultation event we hosted at our Canton, MA headquarters, Point32Health is delighted to share that we’re expanding the series beyond Massachusetts and offering events in other states.
To avoid denials based on missing information needed for Point32Health to conduct a complete prior authorization review, and to avoid delays in patient care, please respond back timely to requests for more information.
The flu season runs from October through April each year, and given the ongoing COVID pandemic, it’s particularly important to emphasize the importance of getting the 2023-2024 flu vaccine to your patients.
Reducing hospital readmissions within 30 days is a considerable priority in health care, leading to increased patient satisfaction and improved outcomes.
Patients taking antipsychotic medications are at increased risk of developing health conditions including diabetes, high blood pressure, abnormal cholesterol and triglyceride levels, and obesity. Yearly screening and regular metabolic monitoring is vital for children, adolescents, and adults on these medications.
As a follow-up to our July 2023 communication regarding the Initiation and Engagement of Substance Use Disorder Treatment (IET) HEDIS measure, which assesses the follow-up care patients receive after a new episode of substance use disorder (SUD), we’d like to offer some additional tips to keep in mind.
Providers and office staff can refer to the following chart to review changes and updates to Point32Health’s Medical Necessity Guidelines (MNGs), information about newly developed MNGs, and more.
As part of our overarching integration work as a combined company, Point32Health has developed the following new, integrated Point32Health Payment Policies.
As a reminder, Point32Health provides coverage for treatment of pelvic floor disorders. Members are eligible to receive clinical evaluation and physical therapy (PT) as outlined in their plan benefits, and providers should use diagnosis code 090.89 when billing for PT for pelvic floor disorders.
As part of our ongoing commitment to collaborating with our valued provider partners, and building on the success of our July claims consultation, we are hosting another claims consultation in October.
Point32Health’s August webinars offer providers the opportunity to ask questions and share feedback while gaining the latest information on products, processes, systems and more. To register, click the links included in this article.
For dates of service beginning Oct. 1, 2023, providers are required to comply with long-term monitoring requirements related to cell and gene therapies, including requests for follow-up clinical data and/or attestation of clinical outcome.
Providers and office staff can refer to the following chart to review changes and updates to Point32Health’s Medical Necessity Guidelines (MNGs), information about newly developed MNGs, and more.
In the wake of the cybersecurity incident we identified on April 17, we have returned our core Harvard Pilgrim Health Care systems, business functions, and tools online and wanted to share an overview of recent announcements.
Point32Health is pleased to announce that we will be opening the doors to our Canton office this summer to host providers for claims consultations. The event will be an opportunity for providers to meet with our Provider Relations team, who will be available as a resource to support you by answering questions you may have about claims.
Point32Health’s July webinars offer providers the opportunity to ask questions and share feedback while gaining the latest information on products, processes, systems and more — and registering is easy!
Providers and office staff can refer to the following chart to review changes and updates to Point32Health’s Medical Necessity Guidelines (MNGs), information about newly developed MNGs, and more.
At Point32Health, we believe collaboration and communication between primary care physicians and behavioral health care providers are pivotal to quality patient care, helping to minimize adverse medication interactions, allowing for better management of treatment, and improving follow‐up for patients with behavioral health and other medical conditions.