Update on medical record review programs
Point32Health will begin to utilize Optum to assist in claims auditing review for additional lines of business, effective Nov. 1, 2025.
New laboratory Payment Policies
We are implementing a new laboratory benefit management program for Harvard Pilgrim Health Care Commercial products, effective for dates of service beginning Nov. 1, 2025.
Reminder for SNFs: Submit SC-1 forms
SNFs: submit a Status Change Form (SC-1) promptly to MassHealth and Tufts Health Plan when a SCO or One Care member is admitted for a stay of two months or longer.
About the HPHConnect secure portal
Learn about HPHConnect, our secure web-based transaction service for Harvard Pilgrim products, including how to register and submit transactions.
About the Tufts Health Plan secure portal
Learn about the web-based transaction service for Tufts Health Plan products, including how to register and submit transactions.
Electronic data interchange services (EDI)
Visit the EDI page to learn more about trading partners, getting set up for electronic transactions and to access companion guides.
Electronic payment
Visit our electronic funds transfer (EFT) page to get started with receiving your reimbursement electronically.
Vendor programs
Learn about vendor partners who conduct utilization management for certain services.
Join the network
We invite you to join us in ensuring that our communities have access to high-quality, equitable health care by becoming a participating provider.
View our plans
Learn more about the diverse range of health plans we offer under our legacy brands, Harvard Pilgrim Health Care and Tufts Health Plan.