The Point32Health Provider Portal offers healthcare professionals a comprehensive, secure digital platform designed to streamline administrative tasks and enhance patient care management. This powerful online tool provides 24/7 access to critical healthcare information and services for providers across various Point32Health networks.
Official Links
What Providers Can Do
The secure portal enables healthcare professionals to perform multiple critical transactions, including:
- Verify patient eligibility and benefits
- Check claim status
- Submit online claim adjustments
- Process payment disputes
- Submit and track referrals
- Provide inpatient notifications
- Submit and receive authorizations
- Access patient personal health records (PHR)
- Review InterQual Smartsheet criteria
- Access clinical quality management reporting
Access and Registration
How to Get Started
Providers are encouraged to REGISTER TODAY for free portal access. The system is designed to be:
- Secure
- Easy to use
- Completely free
Technical Support
For technical assistance, providers can contact:
- Email: [email protected]
- Provider Service Center
System Resources
User Guides
Comprehensive user guides are available in the Training section, offering detailed instructions on:
- Account management
- Eligibility verification
- Claims status inquiries
- Online claim adjustments
MHK Medical Management System
Inpatient notifications and prior authorization requests for specific plans (including Tufts Health Public Plans, Tufts Medicare Preferred, and Tufts Health Plan Commercial) are processed through the MHK Medical Management system via the secure portal.
Privacy and Security
Point32Health emphasizes:
- Secure access
- Confidential information handling
- Compliance with healthcare privacy regulations
Important Provider Reminders
Directory Information
Providers are advised to:
- Review and revalidate demographic information every 90 days
- Complete necessary screenings (e.g., RI Medicaid provider enrollment)
System Maintenance
Point32Health performs scheduled maintenance to minimize disruption:
- Weekend system upgrades
- Typically conducted Friday evenings through Monday mornings
Upcoming Changes and Updates
Recent portal-related updates include:
- Extension of telehealth flexibilities for Medicare members
- Vendor program expansions
- Medical necessity guideline modifications
Supported Plans
The portal supports multiple healthcare plans:
- Harvard Pilgrim Health Care
- Tufts Health Plan
- Stride Medicare Advantage
- Public Plans
- Senior Products
Limitations and Unprovided Information
While the portal offers extensive features, specific details about mobile app availability are not explicitly mentioned in the provided sources.
The Point32Health Provider Portal represents a robust, user-friendly digital solution designed to simplify healthcare administration, improve efficiency, and support high-quality patient care.
Contact Information:
- Technical Support Email: [email protected]
- Provider Service Center available for additional assistance
© 2025 Point32Health, Inc.
FAQ
Is Tufts the same as MassHealth?Tufts Health Unify is a health plan that contracts with both Medicare and Medicaid (MassHealth) to provide benefits of both programs to enrollees.
What insurance company is Tufts?Tufts Health Direct is a Massachusetts qualified health plan (a Commercial product) for individuals and small groups sold on the Massachusetts Health Connector and through HSA Insurance. Tufts Health RITogether provides high-quality health care coverage to individuals enrolled in Rhode Island Medicaid.
How do I submit claims to Tufts?Tufts Health Plan encourages direct electronic claim submission, but also accepts paper claim submissions. All paper CMS-1500 and UB-04 claims must be submitted on standard red claim forms. TUFTS HEALTH PLAN PRODUCTS For which Tufts Health Plan products can claims be submitted electronically?
Is Tufts Health Plan the same as Harvard Pilgrim?As of January 1, 2024, your current Tufts Health Plan will transition to Harvard Pilgrim Health Care. Participants will receive new member ID cards effective 1/1/2024 with the HPHC logo and new group and subscriber ID numbers.
https://www.point32health.org/provider/electronic-services/tufts-health-plan-provider-portal/
The Tufts Health Plan secure portal enables you to access health plan information and perform self-service transactions for your Tufts Health Plan patients, 24
https://www.point32health.org/provider/
Explore our electronic services and learn about our secure portal capabilities for: HPHConnect secure portal · Tufts Health Plan secure portal · View our secure