Client TPA and Network Mapping
This comprehensive reference guide provides essential TPA (Third Party Administrator) and network information for four client organizations. It includes detailed contact information for customer service, provider pre-certification, coverage verification, claims processing, and billing inquiries. The guide also features portal access links for members and advocates, appeals resources, network directory information (UHC Choice Plus and Cigna PPO), and a complete table of medical benefit plan codes for all available plans. This resource serves as a one-stop reference for members, providers, and administrative staff needing quick access to critical healthcare plan information and contact details.
TPA and Network Directory Reference Guide
Client Information Overview
This guide provides comprehensive contact information, portal access, and network details for Third Party Administrator (TPA) services across multiple clients.
TPA Contact Information by Client
Cliff Berry
TPA: TPA
Customer Service: 800-532-7575
Provider Pre-certification (MUST call): 877-532-5220
Provider Coverage Verification (outside MA, ME, & NH): 866-569-4345
Provider Coverage Verification (inside MA, ME, & NH): 877-734-6995
Claim Status/Issues: 800-532-7575
Patient Pre-certification Line: 800-532-5220, Option 4
Enrollment and Eligibility: 800-532-7575
Billing and Payment Questions: 800-532-7575
Five Star
TPA: HPI
Customer Service: 800-532-7575
Provider Pre-certification (MUST call): 877-734-6692
Provider Coverage Verification (outside MA, ME, & NH): 877-734-6692
Provider Coverage Verification (inside MA, ME, & NH): 877-734-6692
Claim Status/Issues: 800-532-7575
Patient Pre-certification Line: 877-734-6692
Enrollment and Eligibility: 800-532-7575
Billing and Payment Questions: 800-532-7575
Harp Enterprises, Inc
TPA: HPI
Customer Service: 800-532-7575
Provider Pre-certification (MUST call): 877-734-6692
Provider Coverage Verification (outside MA, ME, & NH): 877-734-6692
Provider Coverage Verification (inside MA, ME, & NH): 877-734-6692
Claim Status/Issues: 800-532-7575
Patient Pre-certification Line: 877-734-6692
Enrollment and Eligibility: 800-532-7575
Billing and Payment Questions: 800-532-7575
Software Management
TPA: HPI
Customer Service: 800-532-7575
Provider Pre-certification (MUST call): 877-734-6692
Provider Coverage Verification (outside MA, ME, & NH): 877-734-6692
Provider Coverage Verification (inside MA, ME, & NH): 877-734-6692
Claim Status/Issues: 800-532-7575
Patient Pre-certification Line: 877-734-6692
Enrollment and Eligibility: 800-532-7575
Billing and Payment Questions: 800-532-7575
TPA Portal Information
All clients use the following TPA portal systems:
Member Portal (Clients)
URL: https://healthplansinc.com/members/members-secured/
TPA Portal System
Platform: MESA
Advocate TPA Portal
URL: https://hpi-mesa.javelinaweb.com/
Customer Service Email
Email: customeroutreach@healthplansinc.com
Appeals and Additional Resources
TPA Appeals Website
URL: www.hpitpa.com/your-resources/for-members/forms-resources/
TPA Appeals Document (PDF)
URL: https://hpitpa.com/media/w0xme22m/claimappeal_member_form.pdf
TPA Physical ID Card Requests
URL: https://healthplansinc.com/members/order-id-card/
Network Information by Client
Cliff Berry
Network: UHC Choice Plus
Network Directory: https://connect.werally.com/plans/uhc
Five Star
Network: Cigna PPO
Network Directory: https://hcpdirectory.cigna.com/web/public/consumer/directory/search?consumerCode=HDC001
Harp Enterprises, Inc
Network: Cigna PPO
Network Directory: https://hcpdirectory.cigna.com/web/public/consumer/directory/search?consumerCode=HDC001
Software Management
Network: Cigna PPO
Network Directory: https://hcpdirectory.cigna.com/web/public/consumer/directory/search?consumerCode=HDC001
Medical Benefit Plan Codes
| Client | Plan | Medical Benefit Plan |
|---|---|---|
| Cliff Berry | Base | R2563U7M001 |
| Cliff Berry | Mid | R2563U7M002 |
| Cliff Berry | High | R2563U7M003 |
| Five Star | Plan 3 PPO | R2571CIGNA001 |
| Five Star | Plan 11 High PPO | R2571CIGNA002 |
| Five Star | Plan 36 HDHP | R2571CIGNA003 |
| Harp Enterprises, Inc | Plan 1 PPO | R2572CIGNA001 |
| Harp Enterprises, Inc | Plan 2 PPO HSA | R2572CIGNA002 |
| Software Management | Plan 1 PPO | R2572CIGNA001 |
| Software Management | Plan 2 PPO HSA | R2572CIGNA002 |
Important Notes
- Providers MUST call to pre-certify using the designated pre-certification numbers for each client
- Geographic variations exist for coverage verification within and outside MA, ME, & NH for certain clients
- All portal resources and appeals processes are standardized across HPI-administered clients
- Physical ID cards can be requested online through the designated portal