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For behavioral health admissions, providers should continue to submit the Emergency Service Program (ESP) Notification Form by fax (for Tufts Health Direct, Tufts Health RITogether and Tufts Health Together MassHealth MCO Plan and ACPPs: 888-977-0776; for Tufts Health One Care: 857-304-6304).
Please return this form to email address CCSNForms@tuftsmedicalcenter.org or fax number (617)636-5621.
For more information refer to the Commercial and Tufts Medicare Preferred HMO MHK Portal User Guide. Prior authorization requests can also be faxed to the Precertification Operations Department at 617-972-9409.
Prior authorization requests should be faxed to the Precertification Operations Department at 888-415-9055 (Tufts Health Together, Tufts Health Direct), 857-304-6304 (Tufts Health Unify) or 857-304-6404 (Tufts Health RITogether).
To request a provider manual or PA forms, call MassHealth Customer Service at (800) 841-2900, fax to (617) 988-8973, email to publications@mahealth.net, or write to the following address. Forms can also be downloaded from the MMIS and POSC Information site.
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