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Reminder on referrals
Harvard Pilgrim Health Care·Allergy & Immunology, Cardiology, Dermatology +15 more·Provider Newsletter
We identified it
Jun 20, 2026
Summary
Point32Health (Harvard Pilgrim and Tufts Health Plan) is reminding providers that specialty care services require referrals from the member's PCP, and claims will be denied if services are rendered without proper referrals. Specialists must verify referral requirements and submit referrals through specified electronic portals or fax before providing care.
Action Required
Immediately: Before providing any specialty care to Point32Health members, verify referral requirements by checking member's plan benefits or contacting Provider Service Center. Submit referrals electronically via HPHConnect for Harvard Pilgrim Commercial, secure portal for Tufts Health Plan Senior Products, or by fax (607-509-4297 for Harvard Pilgrim, 617-972-1028 for Tufts Senior Products). For Tufts Health Together members, obtain referrals for out-of-network ACO specialists. Claims will be denied without proper referrals.