Contracting with Well Sense Health Plan

Well Sense Health Plan is assuming direct responsibility for managing the medical provider network that Harvard Pilgrim Health Care helped us develop, which excluded behavioral health, durable medical equipment, routine vision and non-emergency transportation contracts. This means that New Hampshire Medicaid providers who originally contracted with Harvard Pilgrim to deliver health care services to our members now must contract directly with Well Sense in order to continue treating those members. Well Sense is also assuming credentialing responsibilities for new providers and recredentialing for existing providers.

In November 2014, Harvard Pilgrim notified affected providers that their contracts would begin transitioning to Well Sense starting in fourth-quarter 2014 through fourth-quarter 2015. Since that time we have been reaching out to providers prior to contract renewal dates to begin the transition process. Please note that if you do not transition to a contract with Well Sense by October 15, 2015, you will no longer be a participating provider in Well Sense Health Plan’s network.

In addition to the communication described above, here is the cover letter that accompanies the packet of information providers receive in order to contract directly with Well Sense. The letter details the items enclosed in the contracting packet as well as instructions and pertinent deadline dates. Please note that the dates may be different on the letter you receive depending on renewal dates and meeting submission deadlines.

If you have questions about this process, please contact Provider Relations at NHProviderinfo@wellsense.org or call our provider line at 877-957-1300 (option 3).

Letter Sent by Harvard Pilgrim Health Care (November 2014)

Letter Accompanying Contract Packet (March 2015)

Important!

exclamation road sign

Once your original contract with Harvard Pilgrim terminates – and if you do not transition to a contract with us by October 15, 2015 – you will not be reimbursed for services provided to Well Sense members until you transition your contract.