Provider manual

The provider manual includes details on working with WellSense, including:

  • Appeals, inquiries, and grievances
  • Behavioral Health management
  • Billing and reimbursement
  • Care Management services
  • Consumer protections for Qualified Health Plan products 
  • Credentialing
  • Member eligibility
  • Member information
  • Pharmacy services
  • Provider responsibilities
  • Provider resources
  • Quality management
  • Utilization management and prior authorization
  • WellSense product information
111_Massachusetts
Massachusetts provider manual

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112_New_Hampshire
New Hampshire provider manual

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