You’ll find all the information you need to get started in this handy Behavioral Health Quick Reference Guide for Providers. Keep it nearby and share with office staff! It includes tips on using our secure portal, verifying member eligibility, submitting claims and checking claims status, and more!
Our handy training guides and flyers can assist you in doing business with Harvard Pilgrim Health Care and Tufts Health Plan, offering step-by-step instructions on everything from checking member eligibility to submitting claims.
Our secure provider portals enable you to perform transactions — from verifying eligibility to submitting claims, making a referral to checking the status of a prior authorization, and more — 24/7, quickly and easily.
Point32Health is moving to Availity Essentials™ for secure electronic transactions. With Availity Essentials, providers and office staff have a new and improved way to connect with Point32Health and conduct transactions. That’s why we encourage you to register now and begin making Availity Essentials part of your regular workflow. For details on getting started with Availity Essentials, please refer to our Availity Essentials page.
At launch, Availity Essentials will be an additional option, and HPHConnect and the secure Tufts Health Plan provider portal, including MHK, will remain available with their current functionality. You’ll find helpful user guides for our legacy secure portals in the Provider Training Guides section of this site.
For more information on our secure portals, refer to electronic services page.
For Harvard Pilgrim Health Care commercial members
Harvard Pilgrim’s electronic payer ID number is 04271. These resources provide step-by-step instructions for submitting claims electronically in Harvard Pilgrim Health Care’s secure portal HPHConnect: Professional Claims Submission Guide and our new short video. Refer to them at your convenience!
To submit claims by paper, please mail them to:
Harvard Pilgrim Health Care
P.O. Box 699183
Quincy, MA 02269-9183
Getting started with submitting claims to Harvard Pilgrim Health Care via HPHConnect? Check out our new short video guiding you step-by-step through the process or refer to Harvard Pilgrim Health Care’s Professional Claims Submission Guide. For additional guidance, join one of our Behavioral Health Trainings, refer to the HPHConnect User Guides, or view our other quick training videos at your convenience!
For Tufts Health Plan members
Tufts Health Plan’s electronic payer ID number is 04298. Mailing addresses for paper claims submission are as follows:
Point32Health maintains performance specifications for a variety of behavioral health services. Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Refer to the Performance Specifications page for more information.
Learn more about this Massachusetts program to enhance behavioral health for MassHealth members under the age of 21. Priorities include increasing timely access to appropriate services, supporting children with home- and community-based behavioral health services, reducing health disparities, and better integrating behavioral health care. Explore more information on CBHI.
There you’ll find information on a variety of programs and resources, including MassHealth’s Medical Necessity Criteria and Training Services for Family Support and Training Services, In-Home Therapy Services, In-Home Behavioral Services, Mobile Crisis Intervention, and Target Case Management: Intensive Care Coordination.
We offer strong relationships, competitive rates, and a steadfast commitment to delivering a positive provider experience.
Missed a webinar? Looking for a short on demand educational video? We’re here to support you!
Our Behavioral Health Service Navigation program helps connect members with timely access to outpatient care.