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    • November 27, 2017

    The following claim edits are effective for dates of service on or after January 1, 2018. These policies are derived from CMS, the AMA CPT Manual, HCPCS, ICD-10, nationally accredited societies and Tufts Health Plan policy. The following claim edits apply to Commercial (including Tufts Health Freedom Plan), Tufts Medicare Preferred HMO and Tufts... more

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    • November 27, 2017

    Tufts Health Plan requires prior authorization for members to be covered for services from out-of-network providers at the in-network level of benefits. Without prior authorization, members of Commercial plans, including limited network plans, will not be covered for out-of-network services (since those products have no out-of-network benefits),... more

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    • November 27, 2017

    The following claim edits are effective for dates of service on or after January 1, 2018. These policies are derived from CMS, the AMA CPT Manual, HCPCS, ICD-10, nationally accredited societies and Tufts Health Plan policy. The following claim edits apply to Commercial (including Tufts Health Freedom Plan), Tufts Medicare Preferred HMO and Tufts... more

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