One of the well-known private healthcare institutes based in the United States is in a world where healthcare comes first, non-profitable companies like Harvard Pilgrim Healthcare take the initiative to make your health secure by providing various plans for all types of clients. From middleman to businessman, various healthcare plans are provided by this company. One of the most essential decisions you will make in your life is healthcare coverage. Protect yourself and your loved ones by purchasing health insurance that is tailored to your medical and financial needs. Lets get to know about the Harvard Pilgrim Healthcare review from different perspectives and points.
Harvard Pilgrim Insurance Phone Number and Harvard Pilgrim Billing Address for Claims
1-888-333-4742
| Main number | (888) 888-4742 (617) 509-1000 TTY: 711 |
Harvard Pilgrim Insurance Phone Number for Members
| Member Services | 888-333-4742 |
| Mon., Tues. & Thurs. 8 a.m. – 6 p.m | TTY: 711 |
| Wed. 10 a.m. – 6 p.m. | |
| Fri. 8 a.m. – 5:30 p.m. | |
| Behavioral Health Access Center Phone Number | 888-777-4742 |
| (behavioral health eligibility, benefits and claims) | |
| Mon. – Fri. 8 a.m. – 6 p.m. | |
| For Medicare Advantage Plan | 888-609-0692, TTY-711 |
| Oct 1 – to March 31(8 a.m. – 8 p.m. 7 days a week) | |
| Apr1 – Sept 30 (8 AM to 8 PM Mon to Fri) | |
| Medicare Supplement Plan | |
| Mon, Tues & Thurs. 8 AM to 6 PM | |
| Wed- 10 AM to 6 PM | |
| Friday- 8AM to 5.30PM | |
| Fraud, Waste and Abuse Hotline | 617-509-1029, Fax- -617-509-0938 |
Harvard Pilgrim Provider Phone Number :
| Provider Service Center | 800-708-4414, choose option # 1 then 7 |
| Mon, Tue, Wed & Fri. 8AM – 5PM | |
| Thursday- 8:30AM- 5PM | |
| Behavioral Health Access Center | 888-777-4742 |
| Mon to Friday – 8Am to 6PM | |
| Medicare Advantage Plan | 888-609-0692 |
| Oct 1 to March 31 ( 8Am to 8PM all days in week) | |
| Apr. 1 – Sept. 30 (Mon to Friday 8Am to 8PM) |
Harvard Pilgrim Insurance Phone Number for Brokers:
| Broker Employer Service Team | 800- 424-7285 , choose option # 2 |
| (eligibility, billing, benefits and claims) | |
| Mon to Fri 8 AM to 5 PM | |
| Closed for training on Wed 8.30 AM to 10 AM) | |
| Broker Relations | 800-424-7285, choose option # 1 |
| Call for credentialing, licensing and commissions | |
| Mon to Fri (8.30 AM to 5 PM) | |
| Medicare Advantage Plan | 800-424-7285, choose option # 3 |
| Oct. 1 to March 31 | |
| 8 AM to 8 PM (All 7 days in a week) | |
| Apr. 1 – Sept. 30 | |
| 8 AM – 8 PM. Mon to Fri (5 days in a week). | |
| Medicare Supplement Plan | 800-424-7285,choose option # 3 |
| Mon., Tues. & Thurs. 8AM – 6PM | |
| Wed- 10 AM to 6 PM | |
| Friday- 8 AM to 5.30 PM |
Harvard Pilgrim Insurance Phone Number for Employers:
| Broker Employer Service Team | 800-637-4751, choose option # 1 |
| (For eligibility, billing, benefits and claims) | |
| Mon – Friday (8 Am to 5 PM) | |
| Closed on Wed 9 AM to 10 AM |
Harvard Pilgrim Health Care Billing Address for Paper Claim Submission
| Claim Type | Address |
| Commercial (HMO, POS, PPO) and Medicare Enhance (including ancillary and DME claims), | Harvard Pilgrim Health Care P. O. Box 699183 Quincy, MA 02269-9183 |
| Medicare Supplement and Access America (Service performed in MA, ME and NH) and HPHC Choice Plus | Harvard Pilgrim Health Care P. O. Box 699183 Quincy, MA 02269-9183 |
| All behavioral health services | United Behavioral Health/Optum P. O. Box 30602 Salt Lake City, UT 84130 |
| Access America (Service performed outside of MA, ME and NH) | UnitedHealth Integrated Services PO BOX 30783 Salt Lake City, UT 84130-0783 |
| StrideSM (HMO) Medicare Advantage Plans | HPHC Inc. c/o Stride Claims Processing P.O. Box 151288 Tampa, FL 33684-1288 |
| Student Insurance Plan | Harvard Pilgrim Health Care/ StudentResources P.O. Box 809025 Dallas, TX 75380-9025 |
| Pharmacy claims (excluding drugs paid under a medical benefit) | Medimpact 10680 Treena St., 5th Floor San Diego, CA 92131 |
Brokers & Employers
- For Medicare brokers, urgent questions should email at [email protected]
- For commercial brokers and/or employers, urgent questions should email at [email protected].
- For brokers assisting individuals and families looking for coverage in Maine, contact at [email protected]
- New Hampshire contact at [email protected]
Harvard Pilgrim uses optical character recognition (OCR) technology for imaging of paper claims so need to take care of some points during Harvard Pilgrim paper claim submission.
Note:
- Professional claim should be submitted on HCFA-1500 or CMS 1500
- Facility or hospital claim should be submitted on UB-04
- Dental claim should be submitted on ADA J400 Dental Claim Form
What should do to submit Harvard Pilgrim Paper Claims:
- Use proper PO Box number to submit paper claims.
- Fill all fields completely, accurately, and within the designated box on the form.
- Submit all claims on the standard red and white form.
- Use only Blue and Black ink.
What should not to do to submit Harvard Pilgrim Paper Claims:
- Handwritten claim should not be accepted.
- Do not use red ink on claim form.
- Do not overwrite or any unnecessary mark on claim form.
- Do not highlight any field of claim form.
- Not accepted photo copy claim forms.
- Not accepted carbon copy claim forms.
- Not accepted claims submitted through Fax.
Let’s understand more about Harvard Pilgrim Healthcare step by step.
What and where is Harvard Pilgrim Healthcare?
Harvard Pilgrim is one of the best and most beneficial health care services for all the clients based in Canton, Massachusetts, which provides services to the main region of New England in the United States. This is one of the non-profit health care services that believes in serving more than making business. The administrations of Harvard Pilgrim Health Care and Tufts Health Plan declared plans to merge their operations into a new corporation on August 14, 2019. More than 3 million clients in New England and beyond rely on Harvard Pilgrim and its community of enterprises for health benefit plans, initiatives, and services. They are a prominent non-profit health services organization that helps their members and the communities they serve achieve better health.
Harvard Pilgrim is a group of companies that came together and took the initiative to run this pilgrim program, which serves a huge variety of spectrums in which one can get an option for customization of their insurance and health plans, from chronic disease management to making healthier communities among the family for life.
Is Harvard Pilgrim Health Care good?
Harvard Pilgrim is a great organization which offers the resources, training, and leadership needed to help communities become healthier. Its goal is to improve low- and moderate-income families’ and communities’ access to fresh, cheap food in the region. If you are approaching retirement age, you should have healthcare plans in hand that will take care of and provide financial support in the event of an unexpected emergency, not only for you but also for your family members. So, in today’s world where our health is our first priority, Harvard Pilgrim Healthcare guides you towards the accurate and varied plans from which you can get social and health benefits as well as social security, which comes under Medicare and many more.
One can also get the benefit of Harvard Pilgrim, which makes it simple to chat with a behavioral health coach or professional therapist about everything from stressful health issues or life changes to mental healthcare technologies like the Scavello smartphone application and Talk Space virtual therapy service. Starting your own family is not an easy task with respect to healthcare management. One has to do all the preplanning about the health care insurance plans while planning for parenthood too. Making the customer understand the importance of reproductive health in addition to pregnancy, with parenthood, you must select the right plans. You don’t have to worry even for a vit because Harvard Pilgrim Healthcare is ready with the maternity insurance for both the mother and the upcoming new born.
Benefits of Harvard Pilgrim Insurance
Harvard Pilgrim Insurance offers numerous benefits to its policyholders. Let’s take a closer look at what sets it apart from other insurance providers:
- Extensive Network: Harvard Pilgrim Insurance boasts a vast network of healthcare providers, including doctors, hospitals, and specialists. This ensures that you have access to high-quality medical care conveniently.
- Customizable Plans: Harvard Pilgrim Insurance understands that every individual and business has unique needs. Hence, they offer customizable plans that cater to your specific requirements. Harvard Pilgrim Insurance has flexible options, whether you need individual coverage, family plans, or employee benefits.
- Wellness Programs: Harvard Pilgrim Insurance goes beyond traditional coverage by offering wellness programs to promote healthy living. These programs provide resources, incentives, and support to help you maintain a healthy lifestyle.
- Exceptional Customer Service: Harvard Pilgrim Insurance prides itself on outstanding customer service. Their knowledgeable and friendly representatives are always ready to assist you with questions or concerns.
- Online Tools and Resources: Harvard Pilgrim Insurance’s user-friendly online tools and resources make managing your insurance, and healthcare needs easy. Everything is just a few clicks away, from finding healthcare providers to accessing policy information.
- Affordability: Harvard Pilgrim Insurance understands the importance of affordable coverage. They offer competitive rates and work with you to find a plan that fits your budget without compromising the quality of care.
- Well-established Reputation: With a long-standing history in the industry, Harvard Pilgrim Insurance has built a strong reputation for reliability, trust, and quality service. You can rest assured that your healthcare needs are in good hands.
Who owns Harvard Pilgrim Healthcare?
Harvard Pilgrim was founded by merging many other organizations, and all of those came under one roof, named Harvard Pilgrim Healthcare. A few of those companies include names like Health Plan Inc., MedWatch, Trestletree, The Harvard Healthcare Pilgrim Foundation, and The Harvard Pilgrim Health Care Institute’s Department of Population Medicine. As it is a leading non-profit healthcare organization, there is no single owner of the organization. The planning and decision-making are done by creating a committee and everyone’s opinions are considered.
This health care system was founded in the year 1994 by first merging the two organizational bodies named Harvard Community Health Plan (HCHP) and Pilgrim Health Plan. It includes details for the medical system on issues influencing public health and health care delivery, largely through independent government and private sources.
Harvard Pilgrim health care customer service
Let’s understand and get to know how the services are provided to the customer. Are they happy, satisfied, or more than that?
According to the Harvard Pilgrim Healthcare review says that it has never let any of its customers feel unsatisfied because of the variety of plans to fulfill and secure all types of requirements. One can get in touch with the customer care executive to get information about various plans and a detailed understanding of a particular healthcare plan by getting a better explanation of the process.
It’s crucial to double-check activity statements, benefit explanations, and claim summaries to make sure you got the services that were billed to Harvard Pilgrim. Customer service at Harvard Pilgrim Healthcare gives special attention to fraud, waste, and abuse and has different departments to deal with such issues. If one is facing any such issue, they can directly visit the website and call the helpline number or support team to resolve and clarify the doubts or fraud they feel they are facing.
Harvard Pilgrim follows special laws made by the organizations and also follows the state and federal laws of that region. If the organization makes a significant change to its policies, you will be notified by letter or electronic means, as authorized by law. The new notification will also be posted on our homepage, www.harvardpilgrim.org. For participants participating in a student health plan managed by UnitedHealthcare Student Resources and offered by HPHC Insurance Company.
Is Harvard Pilgrim a high-deductible health plan?
To know if the Harvard Pilgrim Healthcare insurance is highly deductible or not, let us first understand what it is and why it is used. The cost of deductible is a portion of the cost of health care services you pay each year before the government steps in. Deductibles keep people from filing false allegations or seeking needless treatment or hospitalization just because they have insurance. High-deductible policies allow you to pay a reduced premium, which saves you money over time.
Sometimes it is said that Harvard Pilgrim has highly deductible health care insurance plans, but it is never like that. The benefits you are getting are much more than that. The cost is decided by the management to maintain the service every customer gets, and your annual payment may be reduced if you choose any HDHP with HSA plans. Even though they have high yearly deductions, they give you a lot of options and benefits in your plan and also allow you to set up a health savings account to aid with medical expenses.
Harvard Pilgrim vs. Blue Shield Insurance
Comparing Harvard Pilgrim Healthcare and Blue Shield Insurance will be just like comparing two different insurance companies. Both have their own pros and cons, which the client needs to select as per their choice. With respect to better quality and more healthcare plans for the people and the communities with their self-employees, Harvard Pilgrim provides you with an option to choose from many. always ranked among the best health plans in the country in terms of quality and member satisfaction. With the personal staff of more than 280 000 doctors and clinicals, it is best for their services. all-time emergency facility available. Harvard medical plans include short-term plans, medical advantage plans, Affordable Care Act plans, Medicare, Medical Indemnity Plans and many more.
Blue Shield also provides various healthcare plans for normal customers as well as for their employees. Some of their plans include global coverage for everything. They provide different healthcare plans for the employees working for Blue Shield, as well as plans for individuals and families, along with Medicare and Medicaid. The qualifications for Medicaid are different from those for Medicare. Individuals eligible for both Medicare and Medicaid are subject to special terms and conditions.
Harvard Pilgrim Insurance Official Website Link:
www.harvarddpilgrim.org
Harvard Pilgrim Insurance Phone Number and paper claim address updated as per latest information from authorized portals and resources, if any discrepancy found please let us know through the contact us page. We will take care of it surely.
Conclusion :
As we went through these multiple parameters of the Harvard Pilgrim Healthcare insurance the reviews says that one must surely start planning and choosing the best among all plans as per the requirement to be prepared for future emergencies. Let’s keep us and our family prepared for any upcoming emergencies and make your future secure. The organization also cares about their employees, which is why they provide a variety of small and large-scale corporate healthcare insurance policies. Their custom-designed healthcare plans will provide your staff with the medical coverage they require.
Frequently Asked Questions
Ans. Learn how Harvard Pilgrim collaborates with members and providers to enhance the quality of your care, including how to ensure you’re getting high-quality care, how to pick high-quality doctors and hospitals, and about Harvard Pilgrim’s quality improvement program.
Ans. Protected health information and personally identifying information, including your name and Social Security card, are examples of personal and medical information. PHI is health records about your physical or mental health state that are used to provide you with health care or to bill you for medical services.
Ans. Harvard Pilgrim Healthcare reviews said that they provides additional services like individual support if one wants to understand what the best plan is for them by understanding their requirements; health coaching to make you understand what is required to be healthy in a daily lifestyle. Helping to plan healthy diets, exercising, controlling diets and many more.
Ans. An absolute yes, Harvard Pilgrim gives you education and information on your drugs, including possible side effects, helpful advice on how to take your meds, and more. In addition, you will receive wellness support from the virtual medium for any specific therapy or treatment that you may require in the event of an emergency.
Ans. This can be a very important think which will help you to know what and every detail of the plans and services provided by Harvard Pilgrim Healthcare insurance. You can visit the website https://www.harvardpilgrim.org/public/home to know everything much more in details.