Member eligibility
Tufts Health Public Plans
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.
Aging Services Access Points for One Care members
If you are a provider and are proposing to treat a Tufts Health One Care 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 One Care Members:
- Home Delivered Meals
- Grocery & Shopping
- Homemaking
- Laundry
- Companion
- Light Chore/Heavy Chore
- Home Health Aide (HHA) * If not part of VNA services
- Supportive Home Care Aide (SHCA)
- IL Peer Support
- IL Skills Training