US Family Health Plan transition

REQUIREMENTS: By December 31, 2026: - Billing team must verify current contract status with Brighton Marine for USFHP coverage. Contact ProviderTeam@brighton-marine.org to confirm direct contracting relationship. - Identify all individual providers in practice who are currently credentialed with Tufts Health Plan for USFHP. Those NOT credentialed must submit credentialing applications to Brighton Marine immediately, as processing time is required before 2027. - Update billing system records to reflect transition of claims processing to Signature Performance (Brighton Marine's subcontractor) effective January 1, 2027. - Alert billing staff that claims for dates of service on or after January 1, 2027 must be submitted to Brighton Marine/Signature Performance, not Tufts Health Plan. By March 31, 2027: - Continue processing legacy claims (dates of service prior to January 1, 2027) through Tufts Health Plan as usual. Do NOT submit these to Brighton Marine. - After March 31, 2027, any remaining pre-Jan 1, 2027 claims must be resubmitted to Brighton Marine or will be lost. Before January 1, 2027: - Providers currently credentialed by Tufts Health Plan Commercial will automatically transfer credentialing status to Brighton Marine through scheduled recredentialing dates; no immediate action needed for these providers. - Monitor USFamilyHealth.org/for-providers/ for updated Provider Manual and operational guidance. - Update internal billing procedures and provider communication to reflect new claims processing contact and requirements. Consequence of inaction: Failure to contract with Brighton Marine or obtain credentialing will result in out-of-network status for USFHP members effective January 1, 2027. Claims for dates of service on or after January 1, 2027 submitted to Tufts Health Plan will be rejected and must be reprocessed through Brighton Marine.