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Behavioral health

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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.}

Claims

How to Submit Claims and Enroll in EFT
Claim Submission User Guide
EDI Claims Companion Guide

For services on or before Dec. 31, 2025 (Nov. 30, 2025 for New Hampshire Medicaid), send claims to Carelon.
For services on or after Jan. 1, 2026 (Dec. 1, 2025 for New Hampshire Medicaid), send claims to WellSense.

^{Does not apply to inpatient claims.}

Prior authorization

Prior Authorizations and Continuity of Care updates
Prior authorization forms for Behavioral Health services
Submitting prior authorization requests on the Provider Portal

Services requiring prior authorization or Plan notification

Massachusetts

New Hampshire

Provider portal

Provider portal guide
How to register

Inpatient prior auth requests

PDF
Video

Outpatient prior auth requests

PDF
Video

Working with us

Policies

Continuity of Care policy
Payment policies
CBHI Timely Access to Care Protocol

Training

Live training
On demand webinars, job aids and more

News and updates

Massachusetts providers
New Hampshire providers

Quick reference guide

The quick reference guide assists behavioral health providers transitioning to the WellSense network.

Insourcing FAQs

Find answers to your questions regarding the transition to insourcing behavioral health at WellSense

Join our network

Benefit from integrated, whole-person care coordination; direct support for administrative inquiries, continuing education tools, and more.

Provider toolkit

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

Access the toolkit

Questions?

We're here to help. Email us at bhproviders@wellsense.org or call us at 888-566-0008.

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