Complaints, Grievances and Appeals

Tufts Health Public Plans is committed to ensuring quality care and services for its providers and members. 

All Tufts Health Public Plans providers and members have a right to:

  • Voice complaints or grievances about Tufts Health Public Plans, the care provided, and those providing care
  • File an appeal regarding any adverse decision made by Tufts Health Public Plans, including service coverage determination as well as administrative denials
  • File an appeal as a member, or as a provider acting on behalf of a member, with the MassHealth Board of Hearings after an adverse action resulting from a final determination (final level of internal Tufts Health Public Plans review) related to a medical necessity or service coverage determination

Please refer to our Provider Manual for complete details of our complaints, grievances, and appeals process.

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