Change in denial process for lack of prior authorization
We’re making a change to our claim adjudication process for ancillary services billed in connection with services requiring prior authorization when the authorization is not obtained.
New!
Our Navigating the Prior Authorization Process Quick Reference Guide is here to help make the prior authorization process easier.
US Family Health Plan transition
We will transition administrative operations of the US Family Health Plan beginning Jan. 1, 2027, sunsetting the Tufts Health Plan Commercial line of business.
OTC drug exclusions and other formulary updates
We will no longer provide coverage for drug products that are explicitly over-the-counter or are prescriptions that have OTC equivalents.
Electronic services
About the HPHConnect secure portal
Learn about HPHConnect, our secure web-based transaction service for Harvard Pilgrim products, including how to register and submit transactions. Learn more
About the Tufts Health Plan secure portal
Learn about the web-based transaction service for Tufts Health Plan products, including how to register and submit transactions. Learn more
Electronic data interchange services (EDI)
Visit the EDI page to learn more about trading partners, getting set up for electronic transactions and to access companion guides. Learn more
Electronic payment
Visit our electronic funds transfer (EFT) page to get started with receiving your reimbursement electronically. Learn more
Prior authorization
Resources
Visit our one-stop shop for Prior Authorization information and materials. Learn more
Vendor programs
Learn about vendor partners who conduct utilization management for certain services. Learn more
Find a provider
Join the network
We invite you to join us in ensuring that our communities have access to high-quality, equitable health care by becoming a participating provider.
View our plans
Learn more about the diverse range of health plans we offer under our legacy brands, Harvard Pilgrim Health Care and Tufts Health Plan.