Tufts Health Plan
Welcome to the Tufts Health Plan page. Here you can download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Web site to obtain and check authorizations.
If you have any questions about the NIA Program, please contact your dedicated NIA Provider Relations Manager, Meghan Murphy.
Update on COVID-19
Effective November 1, 2016
Massachusetts Imaging Prior Authorization Form
http://www1.radmd.com/authorizations/state-authorization-requirements-and-clinical-criteria.aspx
Documents
Codes highlighted in yellow do not require pre-authorization or medical necessity review for members under 18 years.
- RadMD Flyer
- RadMD for Ordering and Imaging Providers
- RadMD Pain Managment (Injection) Quick Start Guide
- RadMD Pain Managment (Surgery) Quick Start Guide
- RadMD Quick Start Guide
- RadMD Upload Feature
Spine Management and Joint Surgery
- Changes to Spinal Conditions Management Program
- Interventional Pain Management Checklist
- Spine Care Program Interventional Pain Management Frequently Asked Questions
- Spine Care Program Spine Surgeries Frequently Asked Questions
- Spine Management Provider Training
- Spine Pain Management Quick Reference Guide for Ordering Physicians/Surgeons
- Spine Surgery Checklist
- Tufts Health Plan Joint Surgery Provider Training PPT
- Tufts Health Plan FAQ - Joing Surgery
- Tufts Health Plan Ordering Provider QRG Joint Surgery
- Tufts Health Plan Spinal Conditions Management and Joint Surgery Utilization Review Matrix - Effective July 1, 2020
Cardiac Management Effective 1/1/2017
Tufts Health Plan expanded their cardiac study prior authorization program to include Cardiac Catheterizations, Echocardiography, Stress Echocardiography, and Implantable Cardiac Devices effective January 1, 2017.
- Tufts Health Plan Cardiac Frequently Asked Questions
- Tufts Health Plan Ordering Provider Quick Reference Guide
- Tufts Health Plan Imaging Provider Quick Reference Guide
- Tip Sheet
- Tufts Health Plan MPI vs Stress Echo Tip Sheet
- Tufts Health Plan Cardiac Provider Training PPT
- RadMD Quick Start Guide
- RadMD Upload Feature
- RadMD for Ordering and Imaging Providers
Recorded General Trainings
Recorded RadMD Demos
Clinical Guidelines
- Clinical Guidelines
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Refer to the Utilization Review Matrix document to view specific codes managed by NIA