Tufts Managed Medicare Referral Policy
Tufts Medicare Preferred Out-of-Network Referral Policy
At Healthy Aging Physical Therapy, we are proud to offer Outpatient Physical and Occupational Therapy services delivered in the comfort of your home. While we are out-of-network with Tufts Medicare Preferred, patients with this plan still qualify for in-network coverage of our services through their out-of-network benefit.
How to Access Our Services Using Tufts Medicare Preferred
Tufts Medicare Preferred allows patients to receive medically necessary services from out-of-network providers at in-network rates, when your Primary Care Physician (PCP) submits an Out-of-Network Referral for our services.
Here’s what your PCP needs to include in the referral:
Request for Outpatient at Home Physical and/or Occupational Therapy at Home with Healthy Aging Physical Therapy, NPI #1366050106, submitted on a Tufts Health Plan Out of Network Referral Form.
If your PCP is not familiar with this form, they can request them from Tufts using this form:https://www.point32health.org/provider/wp-content/uploads/sites/2/2024/09/Provider-Requisition-WB-Mason-form.pdf
The Out of Network Referral form then needs to be faxed directly to Tufts at (617) 972-1028
Our Scheduling Policy
To ensure we can provide the best care possible and avoid scheduling delays:
We are unable to schedule your evaluation until we have received notification the referral approval.
As a courtesy, our team will fax your PCP instructions and follow up by phone to assist with the process.
If the referral is not received within two weeks, we will notify of you the delay and request that you call your PCP’s office directly to request the referral or encourage them to complete our request.
What to Say When You Call Your PCP
If you need to follow up with your PCP, here’s what you can tell them:
"I’d like to request an Out-of-Network Referral for outpatient physical or occupational therapy at home to be provided by Healthy Aging Physical Therapy (NPI 1366050106). The referral must be submitted using the WB Mason Out-of-Network Referral form and faxed directly to Tufts at (617) 972-1028."
Need Help?
We’re happy to assist you and your PCP through the process. If you or your PCP have any questions, please call our office at (617) 398-4058 Monday–Friday, between 9:00 AM and 3:00 PM.