Secure Provider Portal Frequently Asked Questions (FAQs)

Last updated: June 1, 2021

As previously communicated in the November 1, 2020 Provider Update newsletter, and effective January 11, 2021, Tufts Health Provider Connect, the secure Provider portal for Tufts Health Public Plans RI providers, was replaced by the secure Provider portal currently utilized by all other Tufts Health Plan lines of business (Commercial products [including Tufts Health Freedom Plan], Tufts Health Public Plans MA products and Senior Products). Now providers contracting with any of Tufts Health Plan's products use the same secure Provider portal.

Refer to the FAQ below for additional information and updates as they become available.

Do I now have access to the same capabilities on the secure Provider portal as I did on Tufts Health Provider Connect?
Tufts Health Public Plans providers and office staff have access to many of the same capabilities they had in Tufts Health Provider Connect. Specifically, users have the ability to view member eligibility, benefits, submit claims via Ability (a secure claim submission provider), submit a PCP change on behalf of a member and more.

Effective March 22, 2021, Tufts Health Public Plans providers now have the ability to submit online claim adjustments through Tufts Health Plan’s secure Provider portal; a feature that was not available on Tufts Health Provider Connect.

What are the benefits of using the Online Claim Adjustments tool? Providers can save time and mailing costs when using the tool's key features, which include but are not limited to:

  • Quick access to check a claim's status or make corrections/adjustments to a claim
  • Ability to submit provider payment disputes with uploading capability
  • Easily return funds

For additional information, updates and instructions, refer to the Tufts Health Plan Secure Provider Portal User Guide and the Online Claim Adjustments quick reference guide.

When did the secure Provider portal replace Tufts Health Provider Connect for Tufts Health RITogether?
The secure Provider portal replaced Tufts Health Provider Connect on January 11, 2021.

Which products does this change apply to?
This change applies to Tufts Health RITogether. Now the secure Provider portal is currently used by all of Tufts Health Plan's products.

How do I access the secure Provider portal now that it has replaced Tufts Health Provider Connect?
Providers are able to access the secure Provider portal via Tufts Health Plan’s public Provider website here.

Do I need to register for the secure Provider portal?
If you are a provider that has never used the secure Provider portal for other Tufts Health Plan lines of business, you will need to register. If you have not yet registered for the secure Provider portal, refer to Tufts Health Plan’s public Provider website for registration instructions.

Providers contracting with Commercial products (including Tufts Health Freedom Plan), Tufts Health Public Plans MA products and/or Senior Products, who have an existing account on the secure Provider portal, do not need to register for access again. Providers can now access and submit information for Tufts Health RITogether members using their existing account.

If I am already registered for the secure Provider portal for other lines of business, do I need to take any action?
As a senior access administrator (SAA) on the secure Provider portal, Tufts Health Plan encourages SAAs to confirm that their staff also register for the secure Provider portal and are set-up with the proper access. Note: User access for the secure Provider portal is at the NPI level. User access for Tufts Health Provider Connect was at the TIN level.

How do I submit behavioral health requests and all other authorization requests for Tufts Health RITogether members?
To submit a behavioral health (and all other) authorization requests for Tufts Health Plan RITogether members, fax the proper authorization request form to Tufts Health Plan at 857.304.6304. For questions, providers should call Tufts Health Public Plans Provider Services at 844.301.4093 (RI).

Do I still have access to Tufts Health Provider Connect data?
Yes. Tufts Health Provider Connect claims data, for members of Tufts Health RITogether for dates of service on or after April 26, 2019, is available on the secure Provider portal.

Why am I having issues viewing claims in the secure Provider portal since the portal migration for Tufts Health RITogether?
Users must obtain access to the Payee NPI to view specific claims. To confirm or request access to the Payee NPI, refer to the Tufts Health Plan Secure Provider Portal User Guide.

Who can I call if I have more questions about the portal migration?
Providers should call Tufts Health Public Plans Provider Services at 844.301.4093 (RI).

Cityblock Health Care Plans

I’m a Tufts Health Unify provider with members in Worcester County. Can I access member care plans* through the secure Provider portal?
Providers whose contract includes Tufts Health Unify with members in Worcester County can now access care plans within the secure Provider portal as of July 18, 2020.

For instructions on how to access care plans on the secure Provider portal, reference the Patient Health Tool Navigation for Tufts Health Unify Reference Guide.

*Note: Care plans are documents that include treatment details discussed between provider and member.