CommercialAdministrativeMedium impact
Claims appeals processing timeframe
Harvard Pilgrim Health Care·Provider Newsletter
We identified it
Jun 20, 2026
Summary
The insurance company is experiencing high volumes of claims appeals, resulting in extended processing timeframes. Public Plans and Commercial appeals now take approximately 60 days, while Senior Products appeals take approximately 180 days. Providers should wait for the full review timeframe before contacting for status updates.
Action Required
Immediately: Update billing team workflow to allow 60 days for Public Plans and Commercial appeals processing, and 180 days for Senior Products appeals before requesting status updates. Do not submit duplicate appeals as this delays processing. Train staff to reference Provider Manuals and Claims Appeals flyer for appeal procedures.