Insights and Updates for Providers

Point32Health is partnering with Availity to launch a unified provider portal offering streamlined, single login access and enhanced self-service tools.

Tufts Health One Care members received new 2026 ID numbers and ID cards; please update your billing systems accordingly to avoid denials. 

We have partnered with Home and Community Care Transitions to enhance the management of post-acute care benefits for Tufts Medicare Preferred members.

We’ve streamlined the submission process for ABA authorization requests and extended the accreditation deadlines for certain providers.

Use our secure provider portals to quickly check eligibility, submit referrals and authorizations, manage claims, access guides, and simplify administrative tasks.

Point32Health will update Commercial and behavioral health fee schedules on April 1, 2026, with possible additional changes pending delayed CMS lab rates.

Enhanced Harvard Pilgrim provider search offers easier navigation, personalized filters, and a new “Book Now” feature to help members quickly find needed care.

Starting April 1, 2026, elective inpatient admissions for Harvard Pilgrim Commercial members will require prior authorization and level‑of‑care reviews using InterQual criteria.

RI Medicaid providers must complete state screening and enrollment to stay in the Tufts Health RITogether network and avoid reimbursement interruptions.

Point32Health will now only require prior authorization for microprocessor/complex components of upper and lower limb prosthetic devices.