Resources for behavioral health providers
Have you visited our new behavioral health webpage yet? If not, we encourage you to do so today.
Insights and Updates for Providers
December 2023
Connecticut market exit reminder
Reminder about Harvard Pilgrim Health Care’s withdrawal of fully insured commercial products in Connecticut as of Jan. 1, 2024.
HEDIS MY2023 medical record requests
Learn more about the importance of responding to HEDIS medical record requests.
Register for upcoming trainings
Join an upcoming provider training in December.
Coverage for services provided by LMFTs/LMHCs
Effective Jan. 1, 2024, LMFTs and LMHCs will be recognized as Medicare-eligible providers.
Reminder: Tufts Health Unify becomes Tufts Health One Care
Reminder that Tufts Health Unify is changing its name to Tufts Health One Care on Jan. 1, 2024.
Crisis resource reminder for Massachusetts members
Learn more about Community Behavioral Health Center resources available in Massachusetts.
Reminder: Redetermination for Medicaid patients
Read about how providers can support members through the Medicaid redetermination process.
Reminder: Public Plans initial paper claims address change
As a reminder, the address for Tufts Health Public Plans initial paper claim submissions changed on Aug. 1, 2023.
Child and Adolescent Needs and Strengths (CANS) assessment timeline update
The Massachusetts EOHHS has changed the CANS timeline for re-assessment from 90 to 180 days.
Upgrades to HPI platforms and impact on website access
Learn about HPIs upgraded platforms for providers to view claims, eligibility, and accumulations.
Reminder: QMB Members Exempt from Part A/B Cost-Sharing
Reminders for providers regarding Qualified Medicare Beneficiary enrollee exemption from cost-sharing liability.
MassHealth guidance and new performance specifications
New performance specifications to support MassHealth and Massachusetts EOHHS requirements for certain services are available.
One Care training for Tufts Health Unify
Complete the required two track training on the One Care program.
MassHealth: temporary telehealth flexibilities expired
MassHealth recently announced the expiration of certain waiver services provided via telehealth.
Clinical practice guidelines updates
Point32Health maintains a number of clinical practice guidelines, which you can now find on the Clinical Practice Guidelines section of our provider website.
Reducing avoidable emergency department use
Supporting providers to combat preventable emergency department visits.
Maine mandates and new coverage
Commercial medical necessity guideline updates to align with recent legislation in Maine.
Medical criteria updates: Stride, Tufts Health One Care, Tufts Health Medicare Preferred
Updated criteria and medical necessity guidelines for Jan. 1, 2024.
Point32Health Medical Necessity Guideline Updates
Medical necessity guideline updates.
Point32Health medical drug program updates
New and updated medical drug prior authorization programs.
Pharmacy coverage changes
Pharmacy coverage changes for various Point32Health products.
Reminder and clarification of billing requirements for Spravato
Reminder and clarification on billing for Spravato nasal spray.
Pharmacy program reminders
Coverage reminders related to our Pharmacy program.
Urine Drug Testing Payment Policy integration
Urine Drug Testing coverage and payment policy updates.