Review and Update Tufts Health Plan Provider Directory Information

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October 30, 2020  

All Tufts Health Plan Massachusetts providers have been enrolled in the directory section of ProView by CAQH®. As of January 1, 2021, Tufts Health Plan will begin to no longer accept provider directory edits directly from providers. All Massachusetts providers are directed to ProView to submit updates on their demographic information. On a quarterly basis, please review all information listed for you as an individual provider (or the information for each individual provider whose information you are responsible for updating) to validate that all information is correct and provide updates in ProView as needed. Information that should be validated includes, but is not limited to, availability to see new patients, telephone number, physical addresses (including whether the individual provider provides services at each address listed in the Provider Directory) and network status. Other updates, such as billing and contracts, must still be sent directly to Tufts Health Plan.

Tufts Health Plan is actively working to enroll providers in ProView in the remaining states it services. As of September 2020, all Rhode Island and New Hampshire allied, behavioral health and independently contracted providers had been added to the program. Contracting providers in Rhode Island, New Hampshire, Connecticut, Maine and Vermont will be added to the CAQH directory by June 2021. Providers will receive email notifications from CAQH when they become enrolled in the directory by any health plan. Once enrolled, the next time a provider logs in to ProView, they will be prompted to review their existing information as well as correct and add more details about their practice.

The directory program engages providers in reviewing and maintaining up-to-date provider directory information to help ensure health care consumers have access to accurate provider demographic information when seeking health care services. Every three months, providers will be prompted to confirm their information. If nothing has changed, providers will still need to reconfirm that data. If changes or updates are needed, providers may do so at any time and reconfirm their new data is accurate.

Once providers are enrolled, their provider directory information (including demographic data) will be transferred to Tufts Health Plan by CAQH so providers will no longer need to notify Tufts Health Plan of these changes directly. Note: This change applies to directory information only.

Contracting and billing questions should still be directed to Tufts Health Plan. Providers can update billing addresses by completing the appropriate Provider Information Change form and selecting “billing” as the address type. For more information on which form to use, refer to the How to Update Your Practice and Billing Information article.

For more information about the provider directory, including a brief demonstration video by CAQH of how the system works, visit the CAQH website.