Behavioral health

Days

We recognize and deeply appreciate the essential role behavioral health providers play in the lives of those we serve. Below you will find tools and resources for working with WellSense and our members. If you need additional assistance, please contact us at bhproviders@wellsense.org.

Where to submit claims

Member's plan type Date of service Send claims to
New Hampshire Medicaid On or before Nov. 30, 2025 Carelon
  On or after Dec. 1, 2025 WellSense
All other products in Massachusetts and New Hampshire On or before Dec. 31, 2025 Carelon
  On or after Jan. 1, 2026 WellSense

Does not apply to inpatient claims.

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Claims

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Prior authorization

Services requiring prior authorization or Plan notification

If after seven business days you have not received an update and would like to inquire on the status of your UM request:

  • Send a secure email to BHUMAuthInquiry@wellsense.org
  • Include the name of the WellSense member and the authorization information you are seeking.
  • We are committed to providing an update within two business days.
  • Please note that any UM notification delays will not put your request at risk for medical necessity denial.
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Provider portal

Inpatient prior auth requests

Outpatient prior auth requests

Working with us

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Resources
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Insourcing FAQs
Find answers to your questions regarding the transition to insourcing behavioral health at WellSense
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Join our network
Benefit from integrated, whole-person care coordination; direct support for administrative inquiries, continuing education tools, and more.
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Provider toolkit

Our toolkit contains resources to help identify and treat members needing behavioral health support for dozens of conditions.

Access the toolkit