WebCall your dedicated Member Advocate team at (888) 333-4742. HARVARD PILGRIMS Hospital Prefer Tiered Hospitals In limited instances, some hospitals may be excluded from the Primary Choice network regardless of the hospitals tier status. WebChoiceNet Tiered Hospitals ChoiceNet, our tiered network product, includes thousands of Harvard Pilgrim-participating doctors and clinicians, plus more than 130 hospitals, who Rehabilitation Services Rehabilitation Services Insights & Updates for Brokers - July 2023 - Harvard Pilgrim Health WebWhen you receive care at a Tier 1 provider, you pay less. Cambridge, MA 21 Highland Avenue, Suite 25 Likewise, some affiliated provider group practices may be excluded regardless of the physician groups tier status. (617) 499-6760, Mount Auburn Hospital Rehabilitation Services Beverly, MA is a Tier 3 hospital for the Independence Plan. GIC Product Updates Effective July 1 - Harvard Pilgrim Health Care Tier 1 Providers: $300 member / $900 family Tier 2 Providers: $300 member / $900 family Tier 3 Providers: $300 member / $900 They can answer questions about medical benefits and claims, help you find care, connect you with a lifestyle coach Dedham, MA How it Works The copayment amount you pay for covered services will depend on the tier that the providers and hospitals are assigned. Harvard Pilgrim Health Care looks forward to serving you. WebThe 2022-2023 plan year for Harvard Pilgrim and the Group Insurance Commissions (GICs) Primary Choice HMO and Independence Plan POS begins on July 1, 2022. Burlington, MA What is the overall deductible? Join Our Network - Harvard Pilgrim Health Care - Provider Provider tiering - Harvard Pilgrim Health Care - Microsites Beth Israel Deaconess Hospital Plymouth, Mary Alice Arakelian Physical Therapy & Rehabilitation Services, Mount Auburn Hospital Rehabilitation Services, New England Baptist Hospital Physical & Occupational Therapy, Addison Gilbert Hospital Outpatient Rehab, Lahey Rehabilitation Services, Burlington. Harvard Pilgrim placed its participating physicians and hospitals into one of two tiers for the Primary Choice plan and one of three tiers for the Independence Plan, based on cost and quality performance. 330 Brookline Ave. Schedule of Benefits - Harvard Pilgrim Health Care Please note, if your CHA or BIDMC provider is also in the Harvard Pilgrim or UnitedHealthcare networks, they are still considered a Tier 1 provider.Harvard Pilgrim Health Care and UnitedHealthcare Options PPO United Behavioral Health Network Tier 3:All other non-network providersYou'll pay the highest cost share when you choose out of network providers. AJH Physical Therapy (781) 372-7060, LOCD Outpatient Rehab Needham, MA Find providers in the ChoiceNet network and know their tiers. Beth Israel Deaconess Medical Center - Harvard Pilgrim Health How It Works - harvardpilgrim.org WebThis plan includes a tiered provider network called ChoiceNet. * If you live 20 or more miles from a Tier 1 BILH primary care provider (PCP) and you live within Harvard Pilgrims (781) 744-8645, Lahey Rehabilitation Services, Burlington (978) 499-2370, Mary Alice Arakelian Physical Therapy & Rehabilitation Services 199 Reedsdale Road Providers located outside of New England are covered or emergency care only. 67 South Bedford Street, Suite 101E Rehabilitation Medicine Department WebHow the three tiers work Using national quality benchmarks, as well as plan medical expense information, we placed affiliated physicians and hospitals in Tier 1, Tier 2 or Tier * If you live 20 or more miles from a Tier 1 BILH primary care provider (PCP) and you live within Harvard Pilgrims Harvard Pilgrims ChoiceNet 830 Boylston Street Including BID-Milton, BID-Needham and APG/BID Welcome employees! In these plans, members pay different levels of cost sharing depending on the tier of the provider delivering a covered Additional Tier 1 physical, occupational and speech therapy providers. 10 Cordage Park Circle, Suite 225 (617) 754-9100, BIDMC Needham WebThe Harvard Pilgrim Independence Plan Massachusetts 2 The Hospital Tiering section on page 3 describes how Participating Hospitals are tiered and the applicable cost sharing The July 2023 broker newsletter features everything you need to know about system restoration including broker commission payments, premium billing, System update - Point32Health (978) 739-7400, Lahey Outpatient Center, Lexington Every doctor and hospital participating in your plans networks meets stringent nationally-accepted quality standards. In-Network: Cambridge Health Alliance (CHA) and CHA ReferredSearch CHA providers and facilities, Search Harvard Pilgrim Health Care providers and facilities*. 73 R Chestnut Street Please note, if Gloucester, MA (978) 304-8700, Winchester HospitalPhysical & Occupational Rehabilitation. (617) 313-1143, Beth Israel Deaconess Hospital Plymouth ChoiceNet Tiered Hospitals 2022 - Harvard Pilgrim Health 25 Storey Avenue, Suite 11 Use the Find a Doc tool to find contact information for participating Tier 1 hospitals: Or, you may also receive Tier 1 services at one of the many outpatient rehabilitation departments within the BIDMC family: BIDMC Boston That means cost sharing for services with physical, occupational and speech therapists who bill as part of the hospital will have Tier 1 cost sharing. Health Plans Inc. | CHA | Provider Network Beth Israel Lahey Health - Harvard Pilgrim Health Care 725 Concord Ave., Suite 5100 Cordage Park However, not all doctors and hospitals charge the same amount. Childrens Hospital (Boston, Mass.) 5 Federal Street Health Plans Inc. is a Harvard Pilgrim company Copyright 2023, Harvard Pilgrim Health Care and UnitedHealthcare Options PPO, Search Harvard Pilgrim Health Care providers and facilities, MetroWest Medical Center Framingham/Natick. 298 Washington Street Your cost-share is determined by the tier associated with your provider of choice. Milton, MA Tier 1:Cambridge Health Alliance (CHA) and Beth Israel Deaconess Medical Center (BIDMC)You'll receive the highest level of benefits and pay the lowest cost share when you choose from providers and facilities of CHA and BIDMC, and the facilities listed below. WebHarvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of Connecticut, Harvard Pilgrim Health Care of New England and HPHC 625 Mount Auburn Street (617) 499-5011, New England Baptist Hospital Physical & Occupational Therapy Due to separate contract arrangements, some Tier 3 hospitals that are excluded from the Primary Choice network may be participating behavioral health facilities. Using national quality benchmarks, as well as plan medical expense information, we placed participating hospitals and physician groups in Tier 1, Tier 2 or Tier 3. Plymouth, MA If you are looking for a physical, (781) 453-3025, BIDMC Milton 480 Maple Street Lexington, MA WebTo join our network, please complete and submit the following materials to Harvard Pilgrims Provider Processing Center for review. WebHarvard Pilgrim placed its participating physicians and hospitals into one of two tiers for the Primary Choice plan and one of three tiers for the Independence Plan, based on cost and (978) 463-1336, Mount Auburn Hospital Rehabilitation Services All Groups. *Care received from Harvard Pilgrim Health Care providers and facilities is covered only when referred by a CHA provider. Boston, MA Tier 2:Harvard Pilgrim Health Care and UnitedHealthcare Options PPOYou'll pay slightly more cost share when you choose HPHC and United Healthcare providers. Providers tier assignments may change at any time (e.g., when they change practice affiliations). See more, and save more with EyeMed! So weve separated providers into three tiers (levels). Cambridge, MA Plymouth, MA WebHarvard Pilgrim Health Care looks forward to serving you. 41 Mall Road 3 Village Green North, Suite 331 Health Plans Inc. | CHA | Health Care Providers - Search our Danvers, MA Newburyport, MA (978) 283-4000, Beverly Hospital Outpatient Rehab Danvers, MA 2023 Harvard Pilgrim Health Care, Inc. All rights reserved. (617) 754-5069, Addison Gilbert Hospital Outpatient Rehab 2023 Harvard Pilgrim Health Care, Inc. All rights reserved. WebHarvard Pilgrim Health Care and UnitedHealthcare Options PPO You'll pay slightly more cost share when you choose HPHC and United Healthcare providers. However, please note that Harvard Pilgrim contracts with these providers at the hospital level, and not with individual physical, occupational and speech therapists. WebEyeMed-affiliated Providers. HARVARD PILGRIMS ChoiceNet Tiered Hospitals - Belmont (508) 830-2182, Beth Israel Deaconess Hospital Plymouth 77 Herrick Street, Suite 202 Burlington, MA If you are looking for a physical, occupational or speech therapy provider, please be aware that providers who are part of Tier 1 hospitals are also Tier 1 providers. Who manages behavioral health for Harvard Pilgrim? [FAQ!] It has been included as a participating hospital for the Primary Choice network at Tier 2 because it is a specialized pediatric hospital. WebTier 1: Cambridge Health Alliance (CHA) and Beth Israel Deaconess Medical Center (BIDMC) You'll receive the highest level of benefits and pay the lowest cost share when Please be assured that the physical, occupational and speech therapy providers who provide services at Tier 1 hospitals are Tier 1 providers, and cost sharing for services with these providers who bill as part of the hospital will have Tier 1 cost sharing. Newburyport, MA Chestnut Hill, MA If a physician group didnt have sufficient data to rank, the affiliated doctors were placed into Tier 2. (781) 744-8648, Lahey Rehabilitation Services, Danvers Out-of-Network: Providers are covered for emergency care only. WebWhen you receive care at a Tier 1 provider, you pay less. First Floor You may receive care from any healthcare provider you choose. Pinehills Important: The Primary Choice network generally includes only Tier 1 and Tier 2 physician groups and hospitals. WebChoiceNet, our tiered provider network, includes thousands of Harvard Pilgrims participating doctors and clinicians, plus 184 hospitals, who have met Harvard Pilgrims Providers who work for more than one practice may be in more than one tier; what you pay will depend on the practice location you visit. With the EyeMed discount plan, members receive discounts on frames and lenses at participating (617) 754-5069, New England Baptist Hospital Physical & Occupational Therapy For status inquires on your application, 40 Allied Drive System update Section last updated July 20, 2023 Point32Health has communicated to our provider partners that they should continue providing care to Harvard Pilgrims ChoiceNet Tiered Hospitals - HSA Insurance WebHarvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of Connecticut, Harvard Pilgrim Health Care of New England and HPHC 16 Hayden Avenue HPI | Discounts & Savings | Vision Programs - Health Plans Inc. (508) 830-2182, Anna Jaques (978) 922-3000, Lahey Hospital & Medical Center