How To Submit Claims To Tufts Health Plan

Coverage: Tufts Health Plan commercial HMO, EPO, POS, and PPO manual. Do not transfer these rules to public plans, senior products, or Harvard Pilgrim.

Tufts Health Plan claims guidance from the reviewed sources: Electronic claims. Confirm the member plan and claim type before using a payer ID or paper address.

At a glance

• The commercial claims chapter describes electronic claims and official red CMS-1500/UB-04 paper forms. Rejected claims must still be received within the original filing period; retain electronic submission proof.

Submission channels

• Electronic claims
• Official red CMS-1500 or UB-04 paper claims

Electronic claims payer IDs

• Not clearly published in the researched sources.

Paper claims addresses

• Not clearly published in the researched sources.

Corrected claims and follow-up

• Not clearly published in the researched sources.

• No direct topic-specific link was captured in the current research set.

Caveats

• Not clearly published in the researched sources.

Provider resources

• Authorization guidance (official)
• Filing guidance (official)
• Claims guidance (official)

Sources

Update notes

Last updated: 2026-10-30.

• Added the currently linked commercial manual and Point32Health authorization guidance. The located claims chapter is dated 2025.
• Preserved separate service, discharge, and primary-EOP triggers. Public-plan and senior-plan rules are outside this record scope.