Request for Claim Review Form and Mailing Information

The following table lists the correct mailing address to submit a Request for Claim Review Form to Tufts Health Plan by product:

Note: Disputes for Senior Products claims denied for lack of Prior Authorization or notification may submit the dispute, Request for Claim Review Form, copy of the EOP and appropriate documentation to SP_Provider_Appeals@point32health.org.
 

Product

Address

Tufts Health Plan Commercial (including US Family Health Plan)1

Tufts Health Plan
Provider Payment Disputes
P.O. Box 251
Canton, MA 02021-0251

Tufts Medicare Preferred HMO

Tufts Medicare Preferred HMO
Provider Payment Disputes
P.O. Box 478
Canton, MA 02021-0478

Tufts Health Plan SCO

Tufts Health Plan SCO
Provider Payment Disputes
P.O. Box 478
Canton, MA 02021-0478

Tufts Health Public Plans2

Tufts Health Public Plans
Provider Payment Disputes
P.O. Box 524
Canton, MA 02021-0524

Registered providers may submit claim adjustments using the secure Provider portal. If you are not a registered user of our website, go to the secure Provider portal and follow the instructions to register.

Refer to the applicable Provider Payment Dispute Policies for more information about submitting payment disputes and/or claim adjustments:

1Commercial products include HMO, POS, PPO, and CareLinkSM when Tufts Health Plan is the primary administrator.

2Tufts Health Public Plans products include Tufts Health Direct, Tufts Health RITogether, Tufts Health Together (includes MassHealth MCO Plan and Accountable Care Partnership Plans), and Tufts Health One Care.