- Doing Business with Tufts Health Public Plans
- Member eligibility
- Join Our Network
- Complaints, Grievances and Appeals
- Health IT Resources and Initiatives
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.