Insights and Updates for Providers

July 2024

Point32Health non-emergent ambulance reimbursement

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health One Care | Tufts Health Plan Commercial | Tufts Health Plan SCO | Tufts Health RITogether | Tufts Health Together | Tufts Medicare Preferred

Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.

Reminder: Psychological testing and TMS

Harvard Pilgrim and Tufts Commercial | Tufts Health Plan Commercial | Tufts Health Public Plans

Attach Psychological and Neuropsychological Assessment and/or rTMS form(s) to prior authorization requests.

Pharmacy program reminders

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health Plan Commercial | Tufts Health RITogether | Tufts Health Together

Point32Health would like to offer some reminders pertaining to our Pharmacy program.

Pharmacy program reminders

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health Plan Commercial | Tufts Health RITogether | Tufts Health Together

Coverage reminders related to our Pharmacy program.

Step Therapy Protocols and Exceptions

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health Plan Commercial | Tufts Health Plan SCO-Medicaid Only Plans | Tufts Health Together

Learn more about mandatory exceptions in step therapy protocols.

Pharmacy coverage changes

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health Plan Commercial | Tufts Health RITogether | Tufts Health Together

Read more for information on updates to Point32Health’s Pharmacy prior authorization programs.

Pharmacy coverage changes

Harvard Pilgrim and Tufts Commercial | Tufts Health Direct | Tufts Health Plan Commercial | Tufts Health RITogether

Read more for information on updates to Point32Health’s Pharmacy prior authorization programs.