Upcoming training opportunities
We invite you to register for one of our many interactive training sessions during the month of July.
Insights and Updates for Providers
January 2025
Coordination of Benefits Quick Reference Guide
This Quick Reference Guide offers providers tips on how to determine which plans have the primary obligation to provide benefits.
Durable medical equipment updates
Point32Health is assessing our reimbursement platforms and making updates to better manage coding for DME and the application of regulatory requirements.
Updates to facility ER policy and processing rules
Point32Health will begin reviews of facility ER claims to determine the appropriateness of the E/M level of care submitted.
Language interpretation services reminder
Point32Health offers various language interpretation services for members and their providers, who may need assistance beyond their practice’s resources.
Medication Reconciliation – reminder for primary care providers
Point32Health emphasizes the importance of maintaining a standard medication reconciliation procedure to avoid patient medication errors.
Point32Health Medical Necessity Guideline updates
Providers and office staff can refer to this chart to review changes and updates to Point32Health’s Medical Necessity Guidelines.
Point32Health medical drug program updates
Refer to the information in this chart for details on updates to Point32Health’s medical benefit drug prior authorization programs.
Integrated Point32Health Payment Policy: Clinical Trials
We are introducing an integrated Point32Health Clinical Trials Payment Policy, which outlines information pertaining to Harvard Pilgrim and Tufts Health Plan.
Upcoming training opportunities
We invite you to join one of our many interactive training webinar sessions throughout the month of June — register today!
Change Healthcare update: Claims submission connectivity available for all products
All products now have restored electronic claims submission connectivity with Change Healthcare.
Depression screening in the primary care setting
Please conduct depression screening during routine medical office visits.
Coordination of medical and behavioral health care
Collaboration between PCPs and BH providers for high quality patient care.
Join us for Dr. Amishi Jha’s Peak Mind webinar!
Join us for Dr. Amishi Jha’s Peak Mind webinar!
Point32Health’s access to care standards
Access to care policies for Tufts Health Plan and Harvard Pilgrim.
Point32Health Medical Necessity Guideline updates
Read more to review updates to Point32Health Medical Necessity Guidelines.
Upcoming training opportunities
We’re offering several interactive webinars throughout the month of March.
Extension of authorization waiver for admission to MA sub-acute and rehab facilities
We’re extending the authorization waiver for admissions to sub-acute and rehab facilities.
Reminder: balance billing prohibited by Point32Health
As a reminder, Point32Health does not allow balance billing of our members.
Medication for Opioid Use Disorder: buprenorphine resources and training
We offer resources and guidelines for prescribing buprenorphine for opioid use disorder.
Importance of screening for unhealthy alcohol use
Screen for unhealthy alcohol/substance use in the primary care setting.
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.
Point32Health integrates Acupuncture Payment Policy
We have created an integrated Point32Health Payment Policy for Acupuncture.
Upcoming training opportunities
We invite you to join one of our many training sessions for you and your office staff.
Point32Health to acquire Health New England
Point32Health signed definitive agreement with Baystate Health to acquire Health New England.
Our response to Change Healthcare’s cybersecurity incident
Update on Point32Health’s response to Change Healthcare’s cybersecurity incident.
Reminder: Join us for Dr. Jud Brewer’s Hunger Habit workshop!
Workshop on mindfulness and eating for health care professionals with Dr. Jud Brewer!
Living Well program offers free resources to all
Point32Health’s Living Well program offers patients resources for healthier living.
Help us keep directory information up to date
Review and verify the accuracy of demographic data at least quarterly.
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.
Upcoming training opportunities
We’re offering several interactive webinars throughout the month of March.
Our streamlined web experience is here!
Point32Health’s upgraded provider website, with policies and resources all in one place!
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!
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.
Upcoming training opportunities
We’re offering several interactive webinars throughout the month of February.
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.