What should I do if my doctor is not listed as a network provider?

If an individual's doctor is not listed as a network provider with Tufts Healthcare, there are several steps they might consider taking. First, they could review their insurance documents or visit the Tufts Healthcare website to confirm the list of network providers and verify whether their doctor is indeed not included. There may be circumstances in which the doctor was recently added or removed from the network. If the doctor remains outside of the network, individuals may want to explore the option of seeking a referral to a similar healthcare professional who is included in the network. Tufts Healthcare typically offers an extensive directory of network providers, which can assist in finding alternative doctors or specialists within the network. Another alternative is to contact the office of the individual's doctor to discuss the possibility of a cash payment or a self-pay option, if it aligns with the individual's healthcare needs and financial situation. Lastly, individuals might consider asking Tufts Healthcare about the potential for obtaining prior authorization or an exception if they would like to maintain their relationship with that specific provider. For the most accurate and detailed options available, individuals might want to look at the official Tufts Healthcare website, or refer to their specific plan documents for additional guidance on out-of-network services.