Frequently asked questions

All WellSense products will have behavioral health services administered by WellSense. For New Hampshire Medicaid, WellSense will begin administering the benefit as of Dec. 1, 2025. For all other products, including Massachusetts Medicaid, Massachusetts Medicare, Massachusetts ACA, New Hampshire Medicare and New Hampshire ACA, WellSense will begin administering the benefit as of Jan. 1, 2026. To continue seeing WellSense members after this date, you must contract directly with WellSense.

Signing a contract with WellSense, does not change your relationship with Carelon. By signing a contract with WellSense your contract with Carelon is NOT automatically terminated. If you have additional questions related to your contract with Carelon, please contact Carelon at 855-834-5655 or carelonbehavioralhealth.com

Andros is the vendor WellSense has contracted with to assist in building our behavioral health network. They will assist with the contracting process to ensure we have a comprehensive behavioral health network. If you have been contacted by Andros regarding a contract and you have questions, please reach out to them via email at wellsense@andros.co or by telephone at 800-894-0459.

WellSense partners with Verisys, an NCQA-accredited credentialing verification organization that is responsible for collecting and verifying providers’ credentialing information. Verisys may contact providers directly to obtain additional information or documentation. Maintaining communication with Verisys helps ensure timely and accurate completion of the credentialing process.

During the credentialing process, WellSense or Verisys will collect and verify the information contained within your CAQH profile. If additional information or documentation is required, you or your credentialing representative will be contacted. Typically, this process is completed within 30 days of receiving a clean and complete application.

We advise submitting your signed contract and completed credentialing and provider enrollment forms as soon as possible to ensure inclusion for go-live. Providers who are contracted and fully credentialed in advance of go-live, will be listed in the directory.

Yes, the WellSense Provider Portal is an online platform designed for healthcare providers to access essential information to streamline administrative tasks. Through the WellSense portal, providers can check member eligibility, review the status of claims and payments and download necessary reports. Additional detailed information will be made available in 2025.

Carelon remains the behavioral health vendor for WellSense through Nov. 30, 2025, for New Hampshire Medicaid and Dec. 31, 2025, for all other products. Claims for covered behavioral health outpatient services rendered on or before Nov. 30, 2025, for NH Medicaid or before Dec. 31, 2025, for all other products should be submitted to Carelon. Claims for behavioral health outpatient services rendered on or after Dec. 1, 2025, for NH Medicaid or on or after Jan. 1, 2026, for all other products,  should be submitted to WellSense. Carelon will continue to manage inpatient facility claims for covered services that begin prior to Jan. 1, 2026, through discharge or March 31, 2026, (whichever is first), even if the member is there after Jan. 1, 2026. WellSense and Carelon will continue to work together to ensure payments are rendered timely and accurately through this transition. 

Yes, you must grant WellSense access to your CAQH data to be successfully credentialed and continue to be a WellSense behavioral health provider. Additionally, please ensure that your profile is current and regularly attested to in order to prevent delays in the credentialing process.

Please refer to our online provider directory for a full list of participating facilities. Our behavioral health provider network will be open to expansion for behavioral health insourcing.

Please reach out via email to bhproviders@wellsense.org.

Our BH network will be effective Dec. 1, 2025, for New Hampshire Medicaid and Jan. 1, 2026, for all other products. 

Andros is the vendor WellSense is working with to assist in contracting individual, group and clinic providers for our insourced behavioral health network. If you are an individual, group or clinic provider and have not been contacted or have questions, please reach out to Andros via email at wellsense@andros.co or by telephone at 800-894-0459.

WellSense behavioral health contracting team will assist with CBHCs, CHCs, Intermediate LOC and inpatient facilities and can be contracted via email at bhproviders@wellsense.org.

You can also access additional information on the WellSense dedicated Join Our Behavioral Health Network page.  

COC applies only to outpatient and non-24-hour diversionary services (those services which are not overnight). 

WellSense will continue to manage all medications, including those for treating behavioral health conditions. Therefore, there will be no disruption for prescription services for members with current behavioral health prescriptions, including anti-psychotics. 

WellSense members admitted to BH inpatient and 24-hour diversionary services will be managed as follows:
  • Carelon will continue to manage any member who is admitted to a BH inpatient or 24-hour diversionary setting before Dec. 1, 2025, for New Hampshire Medicaid, and Jan. 1, 2026, for all other products, including MassHealth. Carelon will continue to manage those members through discharge or March 31, 2026, whichever comes first. ​
  • WellSense will manage any member who is admitted to a BH inpatient or 24-hour diversionary setting after Dec. 1, 2025, for New Hampshire Medicaid and Jan. 1, 2026, for all other products, including MassHealth.