Medicare AdvantageAdministrativeHigh impact
Important reimbursement reminder: Use the correct member ID for One Care claims
Harvard Pilgrim Health Care·Reimbursement
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Tufts Health One Care transitioned to a Dual Eligible Special Needs Plan on January 1, 2026, issuing all members new ID numbers that begin with 'P'. Claims submitted with old member IDs will be automatically denied and require completely new claim submissions with correct IDs.
Action Required
Immediately: Billing team must update all billing systems to use new Tufts Health One Care member ID numbers beginning with 'P' for services delivered in 2026. Front desk staff must request current member ID cards from patients at time of service. If claims are denied due to incorrect member IDs, submit entirely new claims (not corrections) with proper ID numbers. Failure to use correct member IDs will result in automatic claim denials.