Access Forms

Download important forms below.

Referral Portal Access

Referral Portal Access Form

Referral Form

Referral Form

Appeals

Health Plans General Provider Appeal Form (non HPHC)

Harvard Pilgrim Provider Appeal Form and Quick Reference Guide

Claims

Standard Medical Claim Form

Standard Dental Claim Form

Precertification Process

Precertification vendors and requirements vary by plan. Please click here to visit our Precertification Requests page.