What is the payer ID for Harvard Pilgrim Health Care?

The payer ID for Harvard Pilgrim Health Care is 04271. Alternate IDs seen across clearinghouses include 100141, 10376, 16570, 2742.

How long does Harvard Pilgrim Health Care provider enrollment take?

Harvard Pilgrim Health Care provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Harvard Pilgrim Health Care require CAQH?

Yes. Harvard Pilgrim Health Care uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does Harvard Pilgrim Health Care require ERA enrollment?

Yes. Harvard Pilgrim Health Care requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.

What states does Harvard Pilgrim Health Care cover?

Harvard Pilgrim Health Care operates in MA, NH, ME, CT. Coverage can differ by plan and product line, so confirm the specific plan before you file.

Harvard Pilgrim Health Care

Part of Point32Health

Regional plandentalmedicalvision

Typical enrollment turnaround

60-90 days

Summary

Harvard Pilgrim Health Care is a regional health plan, part of Point32Health, offering dental, medical, and vision coverage operating in 4 states. Claims route under payer ID 04271, with 8 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Point32Health Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID: 04271Also seen as 100141, 10376, 16570, 2742, 6512, HPHC0001 and 2 more
Also known as: Health Plans Inc - HPI, Point32Health, UnitedHealthcare - Harvard Pilgrim
Uses CAQH: YesApplication route: CAQH application only
Service area: MA, NH, ME, CT

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Transaction	Enrollment	Typical setup
Eligibility checks (270/271)	Not required	Immediate
Claim status (276/277)	Not required	Immediate
Professional claims (837P)	Not required	Immediate
Institutional claims (837I)	Not required	Immediate
ERA / remittance (835)	Required	Several weeks

Common questions

What is the payer ID for Harvard Pilgrim Health Care?: The payer ID for Harvard Pilgrim Health Care is 04271. Alternate IDs seen across clearinghouses include 100141, 10376, 16570, 2742.
How long does Harvard Pilgrim Health Care provider enrollment take?: Harvard Pilgrim Health Care provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
Does Harvard Pilgrim Health Care require CAQH?: Yes. Harvard Pilgrim Health Care uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
Does Harvard Pilgrim Health Care require ERA enrollment?: Yes. Harvard Pilgrim Health Care requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
What states does Harvard Pilgrim Health Care cover?: Harvard Pilgrim Health Care operates in MA, NH, ME, CT. Coverage can differ by plan and product line, so confirm the specific plan before you file.

Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.