As a reminder, Point32Health encourages our provider partners to utilize the electronic self-service options available to them via our secure provider portals for ease of use and quick turnaround times.
HPHConnect, Harvard Pilgrim's provider portal, as well as MHK, the medical management tool accessed from within the Tufts Health Plan provider portal, enable you to perform a number of daily transactions in one convenient place. These include submitting referrals and authorizations; finding the status of a claim; providing inpatient notification; confirming member benefits and eligibility prior to initiating care or referring them for a service; and more.
Coming soon! Option to submit authorization and notification requests via MHK for Tufts Health Plan Senior Care Options (SCO) members
We’re pleased to share that beginning Oct. 2, 2026, providers will be able to submit behavioral health and medical prior authorization requests and inpatient notifications via MHK for Tufts Health Plan SCO members.
This option, which is existing for all our other Tufts Health Plan products, is the most direct way to submit requests and provides real-time determinations and the ability to attach clinical documentation.
Prior to submitting requests, providers should check the applicable prior authorization and notification requirements and be sure to carefully review any follow-up requests for more information, including instructions to facilitate the timely submission of all necessary clinical documentation.
Please be aware that at this time, procedures, services, and items requiring notification to a Tufts Health Plan SCO care manager cannot be submitted through the portal. For assistance with identifying the appropriate care manager for notification, our Provider Services team can be reached at 800-279-9022.
We’ve updated our Tufts Health Plan Secure Provider Portal User Guide, MHK Portal User Guide, and Behavioral Health and Substance Use Disorder Portal User Guide to reflect the new authorization and notification request capability for Tufts Health Plan Senior Care Options. We hope this enhancement proves helpful in providing you with an increasingly streamlined experience when working with us!