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.

To continue seeing WellSense members after Jan. 1, 2026, you will need a provider agreement directly with WellSense. If you have additional questions regarding your relationship with Carelon, please contact Carelon directly at 800-397-1630. Representatives are available Monday - Friday, 8 a.m. to 8 p.m. ET.

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.

While most providers can expect to be contacted by Andros, our own WellSense network strategy teams will be reaching out to larger hospital systems, community mental health centers, and community behavioral health centers as applicable in Massachusetts and New Hampshire. 

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 before these dates, should be submitted to Carelon. Claims for behavioral health outpatient services rendered on or after the go-live dates, should be submitted to WellSense. Carelon will continue to manage inpatient facility claims for covered services that begin prior to the go-live dates through discharge, even if the member is still admitted after go-live. WellSense and Carelon will continue to work together to ensure payments are rendered timely and accurately through this transition.