With the insourcing of Harvard Pilgrim Health Care’s behavioral health program in November 2023, we’ve been focused on offering a comprehensive network of behavioral health providers to meet the diverse needs of our members. To ensure access to patient care during this time of growth, providers who were not yet contracted with Harvard Pilgrim — but are participating in Optum/United Behavioral Health’s network — were temporarily considered in network and remained eligible to care for Harvard Pilgrim members.
We’re happy to share that today, our insourced behavioral health program includes a robust network of traditional providers in addition to partners with virtual and digital services designed to engage members in their care. With our network firmly established, effective Jan. 1, 2025, non-contracted Harvard Pilgrim providers will no longer be considered in network. Open authorizations obtained from Optum/United Behavioral Health will be honored through their expiration date.
The good news is that if you’re not yet a contracted Harvard Pilgrim Health Care provider, you may continue to care for our members through Harvard Pilgrim’s continuity of care program, which is outlined in our member handbooks and varies by state (90 days for MA, ME, NH members and 365 days for RI members). Enrollment in continuity of care is automatic so there is no action required of your patients. Beyond the continuity of care period, providers can request additional continuity of care with patients by completing and submitting an Out of Network at In-Network Level of Benefits and Continuity of Care Prior Authorization Form.
The best way to ensure uninterrupted care for your patients is to join Harvard Pilgrim’s behavioral health network. To get started, visit our Join Our Network page for more information and instructions. Our Behavioral Health Quick Reference Guide for Providers outlines everything you need to know about working with us to care for Harvard Pilgrim’s Commercial — including Medicare Enhance, and Medicare Supplement — members. We look forward to our continued collaboration.
Annmarie Dadoly,
Senior Manager, Provider Communications
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Editor
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