Massachusetts Provider Resources

Tools and resources for working with WellSense Health Plan 

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Appeals Backlog
Due to a backlog of provider appeal requests, appeals are currently taking longer than 30 days to process. Please allow additional time for the Provider Appeals team to complete the review of any appeals requests. We apologize for this delay.

We are currently working diligently to decrease our backlog through increased staffing. We expect to return to a 30-day minimum processing time for submitted appeals beginning March 15, 2023. Thank you for your patience.
Application Backlog
We encourage you to log into the provider portal for faster claims and authorization updates. The Provider Enrollment Department is experiencing an application backlog. We ask that you only contact us if your application is over 90 days old. If you have an urgent request, please outreach to your Provider Relations Consultant.

Pharmacy Vendor Transition

Learn about our recent pharmacy vendor transition.

 

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Senior Care Options Training
Take the required Senior Care Options (SCO) Model of Care training. The training is provided annually to newly-participating providers.

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Key Dates

Mar 1 - June 30 MassHealth Plan Selection Period
Nov 1 - Jan 23 Health Connector Open Enrollment
Dec 23 Health Connector Payment for January Plans
Jan 23 Health Connector Payment for February Plans