MedicaidAdministrativeLow impact
Behavioral Health and substance use disorder tools and resources
Harvard Pilgrim Health Care·RI · Psychiatry·Provider Newsletter
We identified it
Aug 10, 2026
Summary
This policy directs Tufts Health RITogether behavioral health providers to centralized resources on Point32Health's website for clinical guidelines, prior authorization requirements, payment policies, and HEDIS best practices. It does not announce new billing rules but consolidates existing guidance in one location.
Action Required
Immediately: Billing team and providers should bookmark and familiarize themselves with Point32Health's Behavioral Health homepage and the Tufts Health Public Plans Provider Manual (Behavioral Health section). Ensure all staff handling behavioral health claims review the Policies, Manuals & Forms page for current prior authorization requirements and medical necessity guidelines. No immediate workflow changes are required, but providers should use these resources to verify prior auth requirements before submitting behavioral health and substance use disorder claims.