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
Provider Portal technical issue
We are experiencing a technical issue where some member eligibility is not displaying properly on the portal. This may impact your ability to check member eligibility, submit claims, or submit prior authorizations We are working to quickly resolve the issue and apologize for any in convenience this may cause. We expect the issue to be resolved within 48 hours. You may utilize paper submission methods in the meantime.
Policies
Find medical coverage criteria and claims payment guidelines for specific services.
Documents & forms
Claims and appeals resources, prior authorization and pharmacy forms and more.
News and updates
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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