We currently partner with Carelon to administer our behavioral health benefits. Because integrated, whole-person care is critical to successful health outcomes, we see an opportunity to improve how WellSense enables coordinated care by administering our behavioral health benefits internally instead of through a third-party vendor. We will begin administering the behavioral health benefits for New Hampshire Medicaid members on Dec. 1, 2025, and for all other products on Jan. 1, 2026. By administering behavioral health services in-house, WellSense strengthens our support of holistic member care and fulfills our mission of delivering health equity to our members.
By joining the WellSense network, behavioral health providers, like you, will have a more streamlined experience through a direct relationship with the health plan. You will benefit from advantages such as integrated, whole-person care coordination; direct support for administrative inquiries, continuing education tools, and other features that will promote your ability to continue delivering high-quality care.
The WellSense advantage
- Health equity
Join a health plan network that goes beyond traditional healthcare by removing barriers to care and providing critical resources to help each member live their healthiest life.
- Increased volume
We anticipate significant growth in Massachusetts and New Hampshire in our existing Medicaid, Medicare, and Commercial plans and from our upcoming entrance to the NH ACA Marketplace.
- Minimize time to reimbursement
Reduce your administrative burden by contracting as a behavioral provider directly with WellSense. We offer an extremely competitive fee schedule, online claims submission, online prior authorization, and we pay more than 95% of properly submitted claims within 30 days of receipt.
- Enhanced member choice and care
Our extensive provider network offers increased access, directly supporting the members in your community. Members with more complex health issues receive additional support through our collaborative Behavioral Health and Medical Care Management programs. Licensed behavioral health clinicians and registered nurses are on staff to help coordinate member care with a focus on the integration of behavioral and medical healthcare.
