New Point32Health webpages to streamline your operations
We are announcing a few integrated webpages to streamline the provider experience, including our Prior Authorization, Forms, and Vendor Programs pages.
We are announcing a few integrated webpages to streamline the provider experience, including our Prior Authorization, Forms, and Vendor Programs pages.
As a reminder, corrected claims submissions should not include documentation of previous payment information, as this may delay processing.
We would like to remind providers that Synagis requires prior authorization, and how to request authorization for the 2024-2025 season.
We’re introducing a streamlined Point32Health Drugs and Biologicals Payment Policy and will require providers to append modifier JW or JZ, when applicable.
Mental health wellness examinations will now be covered annually at no cost to Tufts Health Together members, effective retroactively beginning July 1, 2024.
When billing for psychotherapy services, use the procedure code that most closely reflects the duration of time spent with the patient during the session.
We have made updates to our pharmacy program; please refer to the Pharmacy Medical Necessity Guidelines page on our website for more details.
Point32Health requires prior authorization for coverage of all prenatal testing, including NIPT, which can be requested using the resources provided here.
We recently launched our behavioral health service navigation program to provide personalized guidance for patients seeking information regarding telebehavioral health care.
We have made updates to our pharmacy program; please refer to the Pharmacy Medical Necessity Guidelines page on our website for more details.
Point32Health will return to our standard requirements for all lines of business regarding timely filing and claim adjustments, effective Sept. 1, 2024.
We have outlined reasons why a claim may be retracted, resulting in a negative balance, and ways to resolve a negative balance.
We would like to remind our providers of certain procedures and associated codes that no longer require prior authorization.
We would like to remind providers of notification requirements and billing procedures related to Community Behavioral Health Center services.
We have made updates to our pharmacy program; please refer to the Pharmacy Medical Necessity Guidelines page on our website for more details.
We are removing prior authorization requirements from certain procedures and associated codes in a continued effort to administratively simplify providers’ experience.
Read about updates to Point32Health’s Pharmacy program and our Pharmacy Medical Necessity Guidelines for Harvard Pilgrim and Tufts Health Plan.
Increased reimburse rate for BH telehealth services provided by non-BH providers.
Please keep required billing practices for telehealth services in mind.
Point32Health is expanding coverage for Behavioral Health Integration services.
We’ve developed a new HEDIS® tip sheet for the PRS-E measure.
Pharmacy coverage changes for various Point32Health products.
We’re updating home health care UM requirements for quality and efficiency.
Integrated Point32Health Medical Necessity Guidelines for Non-Emergency Medical Transportation.
A standard authorization form for ABA services has been adopted.
Point32Health provides complex care management services individually tailored to patients.
Point32Health’s chronic condition management programs reinforce clinician treatment plans.
Pharmacy coverage changes for various Point32Health products.
Reminder of our biosimilar strategy for trastuzumab oncology drugs.
We’re consolidating email addresses for submission of information to Tufts Health Plan.
Massachusetts law now requires mandatory exceptions in step therapy protocols.
Annual mental health wellness exams covered at no cost for certain members.
Pharmacy coverage changes for various Point32Health products.
We’re reminding providers of our comprehensive genomic profiling coverage and authorization process.
Use code A4287, not K1005, for coverage of breast milk storage bags.
Integrated Point32Health Ambulance and Transportation Services Payment Policy and reimbursement update.
Pharmacy coverage changes for various Point32Health products.
Attach Psychological and Neuropsychological Assessment and/or rTMS form(s) to prior authorization requests.
Point32Health would like to offer some reminders pertaining to our Pharmacy program.
Pharmacy coverage changes for various Point32Health products.
Learn more about Community Behavioral Health Center resources available in Massachusetts.
Pharmacy coverage changes for various Point32Health products.
Coverage reminders related to our Pharmacy program.
Urine Drug Testing coverage and payment policy updates.
HIV PrEP billing requirements and new ICD-10 code.
Jan. 1, 2024 Pharmacy coverage changes for various Point32Health products.
Preferred products for the bevacizumab, rituximab, and trastuzumab drug classes.
2024 Pharmacy updates: Harvard Pilgrim commercial, Tufts commercial, Tufts Health Direct.
Point32Health provides care management services for adult and pediatric members.
Point32Health’s approach to chronic condition management through patient-centered care.