As a reminder, psychiatric and substance use disorder treatment facilities are required to submit discharge summaries within 24 hours of member discharge from an inpatient, residential treatment, or partial hospitalization program.
The following information is required for Tufts Health Plan members:
- date of discharge
- discharge diagnosis
- medications at discharge
- discharge “to” location
- member phone number
- scheduled aftercare appointments (including dates and provider names)
- mental status at discharge
- Child and Adolescent Needs and Strengths (CANS), if applicable
- CANS is required only for MassHealth Together ACO/MCO members aged 20 and under when discharging from an inpatient program (IP), community-based acute treatment (CBAT) program, or partial hospitalization program (PHP).
Discharge summary information for Tufts Health Plan commercial and Medicare members can be submitted via the THP portal. For Tufts Public Plan members, including those with Unify & SCO, discharge summaries should be submitted to your assigned Behavioral Health Utilization Reviewer or faxed to the appropriate number below.
Tufts Health Together (ACO/MCO)
Tufts Health Plan Senior Care Options (SCO)
Tufts Health Unify
Psychiatric and substance use treatment facilities that are discharging Harvard Pilgrim Health Care members should continue with the current process of coordinating aftercare through Optum, ensuring that all members have scheduled follow-up appointments with the appropriate program or provider. For network questions or assistance, providers can call 888-777-4742.
Director, Provider Relations & Communications
Senior Manager, Provider Communications
Joseph O’Riordan, Susan Panos, Stephen Wong,