Behavioral Health Allied Health Providers
Tufts Health Plan's process for credentialing and contracting Allied Health (i.e., independently licensed) behavioral health (BH) providers is outlined below. This process does not apply to hospital-employed providers, physicians, or providers employed by a physician group or licensed clinic. For information on the contracting for those providers, refer to the MDs, DOs, DPMs or Oral Surgeons page. This information is intended to provide insight into the entirety of the contracting and credentialing processes, highlight expected timeframes and offer contact information for the Tufts Health Plan teams managing specific steps within the process.
Network participation is contingent upon the successful completion of the credentialing and contracting process. For applicants who submit a clean and complete application (i.e. an application with no adverse responses, no quality issues, or missing information), the credentialing and contracting process for allied health BH providers can take up to two months. Applications that are not clean and complete may experience a lengthier application process until all necessary information is provided. The network effective date is the approval date of the credentialing application or the effective date of the signed contract; whichever is later. Providers are notified once the approval process is complete. Incomplete or illegible applications will extend the overall contracting timeframes.
To join the Tufts Health Plan provider network, providers must complete the following steps:
Step 1: Request to join Tufts Health Plan Network(s)
Email a completed Behavioral Health Provider Application (BHP Application) and/or a Behavioral Health Clinic Application (BHC Application) to Tufts_Health_Plan_Credentialing_Department@point32health.org. For Rhode Island Commercial providers, please use the following dedicated email box, RIProviderEnrollment@point32health.org. Note: Providers may also fax the application(s) to 617.972.9591.
Tufts Health Plan will notify the provider once the application is received. The notification provides information on ensuring the credentialing process is completed in a timely manner. Email AHCBehavioralHealth@point32health.org with any questions.
Within 21 days of receipt of the application, Tufts Health Plan will send the provider a contract via email for review and signature. The credentialing process will not begin until a signed and dated contract is received and accepted. The contract will not be counter-executed by Tufts Health Plan and returned to the provider until the credentialing process is completed as outlined in Step 2 below.
Step 2: Credentialing Process
Upon receipt of a properly executed contract the Health Plan credentialing process will begin.
Providers must submit their credentialing application to CAQH ProView. CAQH applications in CAQH ProView with a status of Initial Profile Complete or Reattestation are available to move to the credentialing process. Any other status in CAQH ProView indicates an incomplete application and must be updated and reattested. Note: If the CAQH registration process has previously been completed, log in to update any information that has changed since the last attestation and authorize the release of data to Tufts Health Plan.
Tufts Health Plan will review the credentialing application and required credentialing documentation. Clean and complete* credentialing applications will be processed by Tufts Health Plan’s Credentialing Department within 30-days of being deemed clean and complete. Email Tufts_Health_Plan_Credentialing_Department@point32health.org with any questions during this timeframe. For Rhode Island Commercial providers, please use the following dedicated email box, RIProviderEnrollment@point32health.org. Refer to the Additional Information page for clean and complete credentialing application requirements.
Step 3: Enrollment and Contract Execution
Tufts Health Plan receives daily notifications when providers have successfully completed the credentialing process and have been approved to join the Tufts Health Plan network(s). Within 30 days, Tufts Health Plan will send a fully executed contract to the provider, via email, communicating the in-plan effective date, welcome packet information and behavioral health-related provider resource links. For additional onboarding matierals, refer to Welcome Materials.