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In General

US Family Health Plan will pay “Clean Claims,” which means that they are

  • Submitted on forms with all fields completed accurately
  • Accompanied by a completed referral form, if required
  • Not pended or involving Coordination of Benefits (COB)/Third-Party Liability, or Workers
    Compensation

Please submit all claims within 90 days, coinciding with the date of service, date of discharge, or date of primary carrier's Explanation of Benefits (EOB). Claims received after this time frame will be denied, and the member will not be held responsible for payment. USFHP payer ID is 04298.

Reminder

All paper Referral Forms, Claims Submissions, and Provider Payment Disputes must be mailed to the addresses below. Mail forwarding from Tufts Health Plan - Watertown, MA address has expired. 

Department New PO Box
Claims (Commercial) PO Box 178
Canton, MA 02021-0178
Claims (Senior Products) PO Box 518
Canton, MA 02021-0518
Claims (USFHP) PO Box 495
Canton, MA 02021-0495
Provider Payment Disputes (Commercial, USFHP) PO Box 251
Canton, MA 02021-0251
Provider Payment Disputes (Senior Products) PO Box 478
Canton, MA 02021-0478
Provider Payment Disputes (Public Plans) PO Box 524
Canton, MA 02021-0524

If you are not set up with EDI send first submissions to:

US Family Health Plan
P.O. Box 495
Canton, MA 02021-0495

Providers may submit claims electronically by means of a variety of external clearinghouse sources. Please contact your representative for more information. 

For complete information about billing, please see the “Billing” section of our Provider Manual.