Insights and Updates for Providers

February 2024

Claims editing alignment

Commercial products

For dates of service beginning July 1, all claims for both medical and behavioral health services, including those performed at community mental health centers, will be subject to claims edits and processed consistently across our claims platforms for the legacy brands.

Information for BH providers with migrating members

Commercial products

If your behavioral health patient has migrated or is migrating from a Tufts Health Plan to a Harvard Pilgrim Commercial product prior to July 1, 2023 and you do not currently participate in the Optum/United Behavioral Health network, please request a single case agreement to provide care seamlessly.