INSURER FILING GUIDE
Tufts Health Plan commercial
Use this public information to prepare your packet, then confirm the route on the insurer's own page.
AT A GLANCE
Claim facts
| Member form | MEMBER REIMBURSEMENT MEDICAL CLAIM FORM Number: COM-30100015-201904 Revision: 4/19 Open the insurer form |
|---|---|
| Portal upload | NO |
| Portal path | No upload path: the claim form directs submission through an offline route; the public portal feature list names claim status and EOB access but not claim submission |
| Mail address | Tufts Health Plan, Member Reimbursement Claims, P.O. Box 214, Canton, MA 02021 |
| Fax | Not published by the insurer |
| Attachments | Patient and subscriber information; provider name, address, telephone, license and state, and treatment setting; diagnosis code and description; service dates; procedure code and description; amount paid; total; proof of services; proof of payment |
| Deadline | Not published by the insurer |
| Outcome and status | Secure member portal > Claims and EOBs |
| Processing time | 30 days for most completed requests |
| Caveats | Point32Health says most Tufts commercial products are transitioning to Harvard Pilgrim and the remaining Tufts commercial product is US Family Health Plan; current product and benefit document control. HMO or EPO ordinary out-of-network benefits may be absent; Medicare and Medicaid excluded |
STEP BY STEP
Filing steps
Source: https://www.tuftshealthplan.com/documents/members/forms/member-reimbursement-medical-claim-form
Read date: 10-09-2026
Research steps
- Confirm that the current Tufts commercial product and benefit document provide out-of-network coverage. Point32Health says most Tufts commercial products are transitioning to Harvard Pilgrim and identifies US Family Health Plan as the remaining Tufts commercial product. https://www.point32health.org/provider/network-plans/our-plans/tufts-health-plan-products
- Download and complete the Member Reimbursement Medical Claim Form, COM-30100015-201904 (4/19), one form per family member per provider. https://www.tuftshealthplan.com/documents/members/forms/member-reimbursement-medical-claim-form
- Have the provider supply the diagnosis and procedure information. Attach proof of service and proof of payment, then sign the member certification. https://www.tuftshealthplan.com/documents/members/forms/member-reimbursement-medical-claim-form
- NOT PUBLISHED: a member portal or app claim-upload path. The public form directs an offline route, and the public portal feature list names claim status and EOB access but not claim submission, so
portal_uploadis NO. https://tuftshealthplan.com/member/employer-individual-or-family-plans/tools-resources/digital-tools/secure-member-portal?lang=en-US - Check the benefit document for the filing deadline. Most completed reimbursement requests are processed within 30 days, and payment is sent to the plan subscriber. https://www.tuftshealthplan.com/documents/members/forms/member-reimbursement-medical-claim-form
- Check the secure member portal for claims and EOBs. NOT PUBLISHED: CMS-1500 treatment, typed or electronic-signature acceptance, and claim upload constraints. https://tuftshealthplan.com/member/employer-individual-or-family-plans/tools-resources/digital-tools/secure-member-portal?lang=en-US
Filing facts
- Portal upload: NO
- Portal: Tufts Health Plan secure member portal
- Portal path: No upload path: the claim form directs submission through an offline route; the public portal feature list names claim status and EOB access but not claim submission
- Mail address: Tufts Health Plan, Member Reimbursement Claims, P.O. Box 214, Canton, MA 02021
- Fax: NOT PUBLISHED
- Attach: Patient and subscriber information; provider name, address, telephone, license and state, and treatment setting; diagnosis code and description; service dates; procedure code and description; amount paid; total; proof of services; proof of payment
- File types: NOT APPLICABLE
- File size limit: NOT APPLICABLE
- Maximum files: NOT APPLICABLE
- One file or separate files: NOT APPLICABLE
- Confirmation: Processed claim and EOB appear in the secure member portal
- Status check: Secure member portal > Claims and EOBs
- Processing time: 30 days for most completed requests
- Member deadline: NOT PUBLISHED
- Deadline basis: YES: benefit document controls
- Mental health route: The common reimbursement form covers psychiatrists and licensed clinical social workers; no separate behavioral-health member filing portal is published
Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.
Read on 10-09-2026 from https://www.tuftshealthplan.com/documents/members/forms/member-reimbursement-medical-claim-form. Confirm the address, fax number or portal path on the insurer's own claims page before you send.