HPI Payer ID: Sending Health Plans, Inc. Claims Electronically

If you bill electronically, the payer ID matters more than the mailing address. For Health Plans, Inc. (HPI), two IDs appear in official material: 04271 and 44273. This guide explains where each comes from, which to pick, and how to avoid the rejections that send a clean claim back to your work queue. For the paper address and the full routing table, see the Health Plans Inc claims address page.

The two published HPI payer IDs

The "WebMD" label dates from an older clearinghouse network name. You do not need to send claims through any particular vendor to use it; what matters is whether your clearinghouse maps 44273 to HPI. If your vendor's payer list shows HPI only under 04271, use 04271.

Why a Harvard Pilgrim payer ID works for HPI

HPI has been part of the Harvard Pilgrim family since 2005 and is now a subsidiary of Point32Health, Harvard Pilgrim's parent. Electronic claims sent under 04271 for an HPI member are identified by the member ID. Harvard Pilgrim's payer ID decision chart makes this explicit: look at the patient's member ID, and if it begins with HH, the destination is payer ID 04271 with HPI shown alongside Harvard Pilgrim.

The same chart shows several IDs that are not for HPI members, which is where billing teams most often slip:

One more detail from that chart: a card that says "UMR" in the top corner, for a service performed in Massachusetts, Maine or New Hampshire, also routes to 04271 with the HPI name. Outside those states it goes to 39026.

Setting HPI up in your clearinghouse

1. Search more than one name. HPI suggests searching your system for "HPI" or "Health Plans Inc", and some systems also let you search by PO Box or ZIP code. Clearinghouses may file it under Harvard Pilgrim instead.
2. Check the payer ID, not just the name. Confirm that the entry you pick carries 04271 or 44273 and supports the transaction you need (837P professional, 837I institutional, 835 remittance).
3. Keep paper as a fallback. If enrollment for remittance or a specific transaction is pending, the PO Box 5199 address on the claims address page still works for paper claims.
4. Ask the right team. For questions about routing under 04271, Harvard Pilgrim's EDI Team is reachable at 800-708-4414 (option 1, then option 3). For plan or benefit questions, call the Provider Services number on the card.

Formatting the member ID

HPI's provider portal describes the patient ID as a 9-digit number that begins with HH. Harvard Pilgrim's electronic claims manual gives two formatting rules that apply to any claim sent under its payer ID: do not include dashes or spaces in the member ID, and use the numeral zero rather than the letter O where an ID contains a zero. A single mistyped character is enough to trigger an eligibility rejection.

Most common electronic rejections, and the fix

Harvard Pilgrim says its response reports come back within 24 to 72 hours for direct submitters and 48 to 96 hours through a clearinghouse, and it asks submitters to call the EDI Team if more than four days (ten for clearinghouses) pass without a response. Those are Harvard Pilgrim's figures for its own EDI intake; HPI does not publish separate timings that we could find. Either way, act on a rejection quickly. A rejected claim was never accepted, so it does not stop the timely filing clock. Our HPI timely filing guide explains why that matters.