Provider Manuals

Tufts Health Plan developed the provider manuals to supply our providers and their office staff with details on the structure, products, policies and procedures of Tufts Health Plan. We recommend that providers and their staff read this manual and reference it on an ongoing basis to obtain the most up-to-date information.

Utilization Determination Review Timeframe grids provide a condensed overview of the requirements for conducting initial reviews and notification request for coverage.

For more information, click on the links below:

• Behavioral Health Designated Facility Manual
• Credentialing
• Commercial Provider Manual
• Utilization Determination Timeframes for Commercial Products
• Utilization Management Policy Manual
• Tufts Medicare Preferred Provider Manual
• Utilization Determination Timeframes for Tufts Medicare Preferred Members
• Delegated Care Management Manual
• Corporate Member-Generated Grievance Policy

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