Tufts Health Plan
Please follow the Enrollment Instructions below to become an electronic submitter for Tufts Health Plan.
Required Documents/Process
To become a direct submitter to the Tufts B2B Gateway system, please send an email to edi_operations@tufts-health.com. In the body of your message let them know you would like to begin submitting 837 files directly to the Tufts B2B Gateway system. Please include your Tufts ID, Tax ID and NPI as well as your Organization's name in your email.
You may also call the Tufts EDI Technology Support Center at 1-888-880-8699 for any questions you may have regarding your enrollment.
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
Enrollment Forms
The Tufts representative should be emailing you 2 forms 2 complete:
One form is called the "Web Based Secure File Exchange (HTTPS) Setup Form". Complete this form with your entity's information.
The other form is called the "EDI Set-up Form". Complete this form with your entity's information. In the "Practice Management System/Computer Vendor" section, enter the name of the organization that created the software you are using to create your 837 EDI files. For Example: If you are using our SolAce EMC software you would enter "SolAce by AXIOM Systems Inc" for Vendor. For Vendor Contact you may put "EDI Helpdesk" (602) 439-2525 option 1.
Testing
Once you have received your Submitter ID and Password from Tufts, please call the Claimshuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to Tufts Health Plan.
Please have 5 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.