CommercialAdministrativeMedium impact
Guide to submitting provider claims appeals
Harvard Pilgrim Health Care·Provider Newsletter
We identified it
Jun 20, 2026
Summary
Point32Health has issued a new guide for submitting provider claims appeals, providing a standardized process for appealing denied or incorrectly reimbursed claims for Harvard Pilgrim Health Care and Tufts Health Plan members. The guide includes a new Provider Claims Appeals flyer with step-by-step instructions and submission requirements that vary by product type.
Action Required
Immediately: Billing team should obtain and review the new Provider Claims Appeals flyer from Point32Health. Update appeals workflow to use the standardized Claims Review Form process outlined in the guide. Train staff on product-specific submission requirements for Harvard Pilgrim Health Care vs Tufts Health Plan appeals. Keep the reference guide accessible for future claim denials.