Prior authorization resources

We’ve developed the following lists and grids to provide guidance on services that require prior authorization and notification by Plan.

Harvard Pilgrim

Harvard Pilgrim Commercial Referral/Auth./Notification Quick Reference Guide
Harvard Pilgrim Stride Medicare Advantage Referral/Auth. Quick Reference Guide
Harvard Pilgrim Stride Medicare Advantage Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines

Tufts Medicare Preferred

Tufts Medicare Preferred (HMO and PPO) Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines

Tufts Health Senior Care Options

Tufts Health Senior Care Options Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines

Tufts Health One Care

Behavioral Health