Now available for Stride: Electronic claims submission with Availity
We’ve established a connection with Availity for 837 electronic claims submission for Harvard Pilgrim Stride (HMO)/(HMO-POS) Medicare Advantage members.
We’ve established a connection with Availity for 837 electronic claims submission for Harvard Pilgrim Stride (HMO)/(HMO-POS) Medicare Advantage members.
Point32Health is making adjustments to certain care management functions to better coordinate on transitions of care for our members.
The Massachusetts BHHL has launched a resource directory — behavioral health providers are encouraged to confirm their practice is listed.
Select Senior Products members can opt into our in-home urgent care program, instED.
A recent CMS memo clarifies coverage associated with the Jimmo Settlement.
Point32Health provides complex care management services individually tailored to patients.
Point32Health’s chronic condition management programs reinforce clinician treatment plans.
Clarification on how to request authorization for oral formula.
Change coming to the way oral formula is requested on authorizations.
Modifier CS should no longer be used and claims with it may deny.
Effective Jan. 1, 2024, LMFTs and LMHCs will be recognized as Medicare-eligible providers.
Reminders for providers regarding Qualified Medicare Beneficiary enrollee exemption from cost-sharing liability.
Updated criteria and medical necessity guidelines for Jan. 1, 2024.
When terminating from network, please identify two alternate available providers.
Point32Health provides care management services for adult and pediatric members.
Point32Health’s approach to chronic condition management through patient-centered care.
The mailing address for all Harvard Pilgrim Stride claims submissions has changed.
Providers who are planning to offer concierge medicine services to eligible members are required to provide advance notice.
New requirements will apply to the 2024 Part B Step Therapy program.
We’ve developed a payment policy illustrating reimbursement, reporting, and billing policies and requirements for services related to serious reportable events and provider preventable conditions for our Harvard Pilgrim Health Care Stride (HMO)/(HMO-POS) Medicare Advantage products.
We would like to provide some reminders regarding the steps a contracted provider must take prior to billing members of our Harvard Pilgrim Health Care and Tufts Health Plan Medicare Advantage plans/Senior Products for non-covered services.
In a continued effort to reduce prior authorization burden on providers and members, effective Sept. 1, 2023 these drugs will no longer require prior authorization through OncoHealth for oncology indications for members of Harvard Pilgrim’s commercial and Stride Medicare Advantage plans.
Integra will soon begin to assume management of the DMEPOS provider network for Point32Health’s Senior Products, starting on July 1, 2023 for Tufts Medicare Preferred and Tufts Health Plan Senior Care Options, and on Sept. 1, 2023 for Harvard Pilgrim Stride (HMO)(HMO-POS) Medicare Advantage.