Tuft’s Health Freedom Plan Transition

Last modified: June 16, 2021

Northeast Health Freedom Plan transition update

Starting Oct. 1, 2021, Tufts Health Freedom Plan (THFP) changes to UnitedHealthcare Freedom Plans.

Overview

Health care professional contracts will begin transitioning to UnitedHealthcare and migration will complete on Jan. 1, 2022.

Regular updates will be posted in Network News

What you need to know

When will groups be migrated to UnitedHealthcare systems?

Starting Oct. 1, 2021, new and existing groups on renewal will migrate to UnitedHealthcare systems. A new Member ID will be issued by UnitedHealthcare, along with potential branding changes to the plans. All remaining groups will migrate to UnitedHealthcare no later than Jan. 1, 2022.

Whose administration policies will apply?

While Tufts Health Plan (THP) is administering THFP, current  THP administration policies will continue to apply. These policies and processes include prior authorizations, referrals, medical necessity guidelines, payment policies, and all submission channels.

Does my THFP health care professional contract apply in New Hampshire?

Yes, THFP contracts apply in New Hampshire and to health care professionals contracted with THFP in states bordering New Hampshire. UnitedHealthcare health care professional contracts apply in all other states.

Whose fee schedules are being used?

For THFP health care professionals in New Hampshire and bordering states, THFP will price claims according to Tufts Health Freedom Plan contracted fee schedules.

Will THP continue to administer THFP plans?

Yes, until plans will start moving to the UnitedHealthcare system upon renewal, beginning on Oct.1, 2021 and concluding on Jan. 1, 2022.

What if I do not have a contract with THFP or UnitedHealthcare?

If you do not have a contract with UnitedHealthcare, please continue to see THFP members as you normally would using our standard administration policies.

Please continue to use THP payment policies, submission channels and guidelines. All claims will be submitted to THP and then UnitedHealthcare will price the claims outside of New Hampshire and border states.

UnitedHealthcare will work directly with you to price claims to avoid member balance billing. 

Where are claims being submitted? 

THP will process claims for all groups until they migrate onto UnitedHealthcare’s systems. At that point, UnitedHealthcare will take over claims processing for that group.

Who will be administering inpatient notifications?

THP will continue to administer inpatient notifications until groups are migrated to UnitedHealthcare’s systems.

Questions?

Call THP Health Care Professional Services at 888-884-2404 for servicing-related questions. 

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