Have you visited our new behavioral health webpage yet? If not, we encourage you to do so today.
Insights and Updates for Providers
Reminder about Harvard Pilgrim Health Care’s withdrawal of fully insured commercial products in Connecticut as of Jan. 1, 2024.
Learn more about the importance of responding to HEDIS medical record requests.
Join an upcoming provider training in December.
Effective Jan. 1, 2024, LMFTs and LMHCs will be recognized as Medicare-eligible providers.
Reminder that Tufts Health Unify is changing its name to Tufts Health One Care on Jan. 1, 2024.
Learn more about Community Behavioral Health Center resources available in Massachusetts.
Read about how providers can support members through the Medicaid redetermination process.
As a reminder, the address for Tufts Health Public Plans initial paper claim submissions changed on Aug. 1, 2023.
The Massachusetts EOHHS has changed the CANS timeline for re-assessment from 90 to 180 days.
Learn about HPIs upgraded platforms for providers to view claims, eligibility, and accumulations.
Reminders for providers regarding Qualified Medicare Beneficiary enrollee exemption from cost-sharing liability.
New performance specifications to support MassHealth and Massachusetts EOHHS requirements for certain services are available.
Complete the required two track training on the One Care program.
MassHealth recently announced the expiration of certain waiver services provided via telehealth.
Point32Health maintains a number of clinical practice guidelines, which you can now find on the Clinical Practice Guidelines section of our provider website.
Supporting providers to combat preventable emergency department visits.
Commercial medical necessity guideline updates to align with recent legislation in Maine.
Updated criteria and medical necessity guidelines for Jan. 1, 2024.
Medical necessity guideline updates.
New and updated medical drug prior authorization programs.
Pharmacy coverage changes for various Point32Health products.
Reminder and clarification on billing for Spravato nasal spray.
Coverage reminders related to our Pharmacy program.
Urine Drug Testing coverage and payment policy updates.