CommercialAdministrativeHigh impact
Reminder: US Family Health Plan transition
Harvard Pilgrim Health Care·Provider Newsletter
Effective date
Jan 1, 2027
We identified it
Sep 6, 2026
Summary
US Family Health Plan (USFHP) administrative operations are transitioning from Tufts Health Plan to BrightonOne effective January 1, 2027. Claims processing will transfer to Signature Performance, and providers must establish direct contracts with BrightonOne before the 2027 plan year to remain in-network. The billing team must verify contract status and ensure proper credentialing to avoid service interruptions.
Action Required
IMMEDIATE: Billing team must contact BrightonOne at ProviderTeam@brighton-marine.org to verify current contract status and direct participation agreement for USFHP. BEFORE 2027 PLAN YEAR: If not already contracted, initiate direct contracting process with BrightonOne to maintain in-network status for USFHP members. VERIFY CREDENTIALING: Confirm all individual providers are credentialed through Tufts Health Plan Commercial for USFHP; if not, submit credentialing applications to BrightonOne immediately to allow processing time before January 1, 2027. UPDATE CLAIMS WORKFLOW: Beginning January 1, 2027, route all USFHP claims to Signature Performance (BrightonOne's claims processor) instead of Tufts Health Plan. TRANSITIONAL PERIOD: Continue processing pre-2027 claims through Tufts Health Plan through April 30, 2027; after that date, send all USFHP claims to Signature Performance. MONITOR UPDATES: Regularly check USFamilyHealth.org/for-providers/ for new Provider Manual, credentialing instructions, and demographic update procedures. Failure to contract with BrightonOne or update claims routing will result in claims being processed out-of-network or delayed, impacting patient billing and revenue cycle.