Massachusetts provider resources
Tools and resources for working with WellSense Health Plan
Appeals Backlog
Due to a backlog of provider appeal requests, appeals are currently taking longer than 30 days to process.
We expect to return to a 30-day minimum processing time for submitted appeals beginning June 1, 2023. Thank you for your patience.
Application Backlog
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 reach out to your Provider Relations Consultant or log into the provider portal for faster claims and authorization updates.
Senior Care Options Training
Refer a patient to WellSense Senior Care Options
Connect your patients to a WellSense Senior Care Options plan to help them receive more benefits in addition to their MassHealth Standard/Medicaid and Medicare coverage. Together, we can help support better health outcomes.
Policies
Find medical coverage criteria and claims payment guidelines for specific services.
Documents & forms
Important news and notices, claims and appeals resources, prior authorization and pharmacy forms and more.
Quality
Additional resources
Important plan information
Select a topic to learn more
Need help?
Contact Provider Relations at 888-566-0008 or provider.info@wellsense.org
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 |
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