Clinical Resources Overview

This section contains clinical resources for physicians and medical practice staff.

Medical Necessity Guidelines: An overview of Tufts Health Plan's Commercial medical necessity guidelines that includes services that require prior authorization and services that are not covered.

Clinical Practice Guidelines: Links to Clinical Practice Guidelines that Tufts Health Plan has adopted.

Health Programs: Information on programs to support preventive health and chronic disease management.

Preventive Health Guidelines: Preventive health and prenatal guidelines from the Massachusetts Health Quality Partners (MHQP).

Tufts Health Plan Medicare Preferred: Information on Tufts Medicare Preferred prior authorization requirements, equipment that is not covered, Medicare approved facilities list and resources.