Our streamlined web experience is here!
Point32Health’s upgraded provider website, with policies and resources all in one place!
Insights and Updates for Providers
February 2024
Waiver of authorization for admission to MA sub-acute and rehab facilities
Temporary waiver of authorizations for admissions to certain Massachusetts facilities.
Join us for Dr. Jud Brewer’s hunger habit workshop!
Workshop on mindfulness and eating for health care professionals with Dr. Jud Brewer!
Expanded access to CGP for advanced solid tumors
We’re reminding providers of our comprehensive genomic profiling coverage and authorization process.
Please respond promptly to provider TIN requests
Please respond promptly to outreach from Point32Health requesting validation of TIN and other info.
New HEDIS tip sheet for EED measure
We’ve developed new HEDIS® tip sheets for your practice.
Prior authorization for SNF care for Tufts Health Plan SCO
Prior authorization for SNF care effective April 1 for Tufts Health Plan SCO.
Harvard Pilgrim commercial fee schedule in effect April 1
Reminder: Harvard Pilgrim’s updated commercial fee schedule takes effect April 1.
Upcoming training opportunities
We’re offering several interactive webinars throughout the month of February.
Enrollment/screening for RI Medicaid providers
Complete screening and enrollment to continue participating in Tufts Health RITogether.
Oral formula authorization request update
Change coming to the way oral formula is requested on authorizations.
Use code A4287 for coverage of breast milk storage bags
Use code A4287, not K1005, for coverage of breast milk storage bags.
Elder abuse and neglect reporting
The health care setting offers a crucial opportunity to screen for elder abuse.
Point32Health non-emergent ambulance reimbursement
Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.
Clarification: Prior authorization on insulin infusion pumps
Authorization required for insulin pumps which work in conjunction with a CGM device.
Point32Health Medical Necessity Guideline updates
Read more to review updates to Point32Health Medical Necessity Guidelines.
Point32Health medical drug program updates
New and updated Point32Health medical drug prior authorization programs.
Pharmacy coverage changes
Pharmacy coverage changes for various Point32Health products.
Adalimumab biosimilar strategy for RITogether
Adalimumab biosimilars added to the Tufts Health RITogether pharmacy formulary.