Insights and Updates for Providers
April 2024Medical Necessity Guideline updates
Learn more about updates to our Medical Necessity Guidelines, including prior authorization updates.
Read moreUpdates to medical drug claims editing logic
As of May 26, 2024, we will be updating claims editing logic to remove edits related to age, lab tests, and drug therapy for Harvard Pilgrim Commercial products and all Tufts Health Plan products.
Read moreMNG update: non-emergency transport
Integrated Point32Health Medical Necessity Guidelines for Non-Emergency Medical Transportation.
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Additional Information
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COVID-19 Provider Resources
You’ll find the latest provider updates on COVID-19 related policies, coverage, and reimbursement here.
Provider Training and Events
Learn about upcoming webinars and office manager meetings, watch 3-minute video training sessions, and access training guides and resources. Plus share your feedback to help us create new events and tools geared to your needs.
What’s Ahead at Point32Health: Integration Updates
Harvard Pilgrim Health Care and Tufts Health Plan combined under the parent organization Point32Health on Jan. 1, 2021. Refer to this FAQ to learn about the work we have done in transitioning our processes and products — and our plans for what’s ahead.