Our Navigating the Prior Authorization Process Quick Reference Guide is here to help make the PA process easier. This step-by-step resource gives you and your office staff helpful tips and guidance for submitting prior authorization requests smoothly and efficiently.
Visit this page for information on the ways to request authorization for medical, pharmacy, and behavioral health services, and links to tools.
Access our prior authorization policies and medical necessity guidelines for both legacy brands in one convenient spot.
Find detailed coverage criteria for medical benefit drugs for Harvard Pilgrim Health Care and Tufts Health Plan.
Access pharmacy clinical coverage criteria and medication request forms.
Reference information on our vendor partners who conduct utilization mangement for certain services.
Our prior authorization and notification grids offer a handy overview.
Access the forms you need for doing business with us.
Our Provider Manuals include additional information on authorization, notification and referrals.
Information about our secure portals and EDI options.