Prior authorization resources

We’ve developed the following lists and grids to provide guidance on services that require prior authorization and notification by Plan.

Harvard Pilgrim

• Harvard Pilgrim Commercial Referral/Auth./Notification Quick Reference Guide
• Harvard Pilgrim Stride Medicare Advantage Referral/Auth. Quick Reference Guide
• Harvard Pilgrim Stride Medicare Advantage Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines

Tufts Medicare Preferred

• Tufts Medicare Preferred (HMO and PPO) Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines
• Tufts Medicare Preferred (HMO and PPO) Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 3.1.25)

Tufts Health Senior Care Options

• Tufts Health Senior Care Options Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines
• Tufts Health Senior Care Options Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 3.1.25)

Tufts Health One Care

• Tufts Health One Care Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines
• Tufts Health One Care Prior Authorization, Notification, and No Prior Authorization Medical Necessity Guidelines (Eff. beginning 3.1.25)
• Tufts Health One Care Behavioral Health Prior Authorization (PA) and Notification Grid

Behavioral Health

• Tufts Health RITogether Behavioral Health Prior Authorization (PA) and Notification Grid
• Tufts Health Together and Tufts Health Direct Behavioral Health Prior Authorization (PA) and Notification Grid