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Always be sure to verify a patient’s eligibility on the date of service to ensure claims payment. You can verify that a patient is a Tufts Health Public Plans member on the date of service via the web or phone. You can also help your patients keep their benefits.
Please note: If you are a primary care provider (PCP), make sure the Tufts Health Public Plans patient is assigned to your panel. We do not pay claims for services you render to a Tufts Health Public Plans patient who is not assigned to your panel unless you obtain prior authorization.
If you are a provider and are proposing to treat a Tufts Health Unify member for which you are not contracted, please check with the local Aging Services Access Point (ASAP). They will have information on whether a service is covered, if prior authorization is needed, and how to bill for such service.
Services that ASAPs coordinate for Tufts Health Unify Members:
Additional Eligibility Information