Duplicate billing logic update
August 2026| Tufts Health One Care| Tufts Health Plan Senior Care Options| Tufts Health RITogether| Tufts Health Together| Tufts Medicare Preferred
In the interest of accurate claims processing, we’re applying duplicate billing logic to claims/services submitted multiple times for the same date of service beginning on Oct. 1, 2026.
Providers should submit all services performed on the same date of service on a single claim. For procedures that are performed multiple times on the same date of service, report the total number of units in the quantity field on a single claim line rather than submitting multiple lines or separate claims for the same procedure code. Billing all applicable services on a single claim helps:
Services billed more than once for the same procedure code and date of service may be subject to reduction in payment, duplicate claim review, and potential denial. This includes duplicate services submitted on multiple claim lines within a single claim or across multiple claims.
If you disagree with the duplicate claim denial, please submit a corrected claim with any necessary updates or corrections to the original claim. Do not submit a new claim for the same procedure code and date of service, as it may be identified as a duplicate.