MFM Health is a member of/participant in/part of a provider organization that is certified as an Accountable Care Organization (ACO) by the Massachusetts Health Policy Commission or a Risk-Bearing Provider Organization (RBPO) by the Massachusetts Division of Insurance.  An ACO/RBPO is a group of health care providers who work together to coordinate your health care and enters into financial agreements with health insurance companies to do so.  MFM Health is participating in an ACO/RBPO called Tufts Medicine Integrated Network (TMIN).

 

Under Massachusetts law, as a patient of an ACO/RBPO, you have the right to appeal a decision by your health care provider on issues such as referrals, timely access to care or limitations on the type or intensity of care.  Issues related to your specific health plan coverage or other issues should be directed to your health insurance company directly.  Under this law, patients with commercial insurance who have a PCP in the TMIN network may file an appeal. This appeals process does not apply to any MassHealth (Medicaid), Medicare or Medicare Advantage patients.

 

You can contact TMIN to file an appeal or to ask about this process.  If you want to file an appeal and need assistance, you can choose a person (such as a spouse, family member, friend, attorney or legal guardian) to act as your representative. 

​

For inquiries or to file an appeal you can contact TMIN Patient Appeals in the following ways:

            By phone:                   (781) 664-5717

            In writing:                  Tufts Medicine Integrated Network

                                                25 Braintree Hill Office Park, Suite 200

                                                Braintree, MA 02184

                                                Attn: Contracting Operations/Patient Appeals

 

TMIN Patient Appeals will give you a written answer to your appeal within fourteen (14) calendar days.  If your appeal involves an urgent medical need, TMIN Patient Appeals will give you a written answer within three (3) business days.

 

For more information or questions, call the TMIN Patient Appeal’s Line at (781) 664-5717.   For more information about your right to file an appeal, contact the Massachusetts Office of Patient Protection via telephone at (800) 436-7757, via email at hpc-opp@mass.gov, visit the Office of Patient Protection’s website at www.masshpc.gov/OPP or visit the Massachusetts Health Policy Commission website at www.masshpc.gov.