Verify eligibility online
Network Health Connect
Log in to Network Health Connect now to verify member eligibility.
Verify a patient's Tufts Health Plan – Network Health membership anytime with instant, online access through Network Health Connect. If you are a primary care provider (PCP), you can also find an up-to-date list of members assigned to your panel when you check eligibility.
NEHEN (New England Healthcare Exchange Network) and NEHENNet
Tufts Health Plan – Network Health participates in NEHEN and NEHENNet, which offer a secure online eligibility verification process for multiple plans.
- If you are a member of NEHEN, you can check member eligibility via your organization’s intranet. If you’re a PCP, you can also find Tufts Health Plan – Network Health members assigned to you when you check eligibility.
- If you are a member of NEHENNet, you can check member eligibility through their website. If you’re a PCP, you can also find Tufts Health Plan – Network Health members assigned to you when you check eligibility.
MassHealth’s Eligibility Verification System (EVS)
Visit MassHealth’s EVS website to verify member eligibility for Tufts Health Together (MassHealth) and Tufts Health Unify (Medicare-Medicaid One Care for people ages 21 – 64) members only. You will need your patient's 12-digit Medicaid Management Information System (MMIS) number, along with your 10-character MassHealth provider number or National Provider Identification (NPI) number and password. If you do not have your patient's MMIS number, you can use their name, gender, and date of birth.
Committee on Operating Rules for Information Exchange (CORE) web service
Use CORE web service to verify member eligibility through real-time transactions. Send us EDI 270 transactions to inquire on the eligibility of members, and we’ll respond with 271 transactions. For more information about CORE web service, email us at EDI@tufts-health.com.