As Tufts Health Plan and Harvard Pilgrim Health Care have combined under the parent company Point32Health, many of the resources you routinely access in doing business with Tufts Health Plan have been migrated to the Point32Health provider website. Click the button below to be redirected there, where you can find Medical Necessity Guidelines, Payment Policies, Pharmacy information, electronic tools, training resources, our Provider Manuals, and more!
While you’re there, be sure to check out the dedicated Behavioral Health area, as well as the integrated Point32Health provider newsletter, Insights and Updates for Providers.
Be in the know! Our monthly provider newsletter, Insights and Updates for Providers, is posted online monthly. Click below to view the current issue. To receive a copy directly to your email, please subscribe.
Provider manuals assist you with doing business with Tufts Health Plan.
Payment policies assist you with submitting claims to Tufts Health Plan.
Tufts Health Plan's clinical practice guidelines help ensure quality preventive care and care management.
Credentialing and contracting are Tufts Health Plan's formal processes for adding providers to the Tufts Health Plan network and ensuring these providers give members quality care consistent with recognized managed care organization industry standards.
Enjoy the cost and time-savings of one-stop access to member eligibility, claims, authorization information, and more. We will walk you through the registration process.
Tufts Health Plan offers a wide range of electronic solutions, including member eligibility status, benefit information, claim submission, claims adjustment functionality and clinical information.
Tufts Health Plan recognized for its quality and performance Tufts Medicare Preferred HMO and Tufts Health Plan Senior Care Options Plans Earn Highest Rating from Centers for Medicare and Medicaid Services.
Tufts Health Plan works with vendors to review certain claims and authorizations