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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

October 2013

Harvard Pilgrim Collaborates on New Hampshire Medicaid Program


Effective December 1, 2013, Boston Medical Center HealthNet Plan (BMCHP) will begin serving New Hampshire Medicaid members under its business name outside of Massachusetts, Well Sense Health Plan (Well Sense). Open enrollment for current Medicaid enrollees began in mid-September, and Well Sense is one of three health plans from which enrollees can select. Harvard Pilgrim Health Care of New England has partnered with BMCHP to develop and maintain a comprehensive network of acute care hospitals, primary care providers, and specialists for Well Sense’s New Hampshire Medicaid program.

Harvard Pilgrim is responsible for contracting, credentialing, and maintaining this network. BMCHP administers all other aspects of Well Sense, including care management, verifying eligibility, claims submission and payment, utilization management, and prior authorization requests. BMCHP, which was founded by Boston Medical Center in 1997, has more than 15 years of developing programs for the underserved and currently offers a Massachusetts Medicaid program that is ranked in the top 10 Medicaid plans in the nation according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Rankings 2013-2014. BMCHP also continues to maintain Excellent Accreditation from NCQA as a Medicaid health maintenance organization.

The Well Sense provider web site offers an overview of the program for providers as well as FAQs, the provider manual, and a variety of other resources. If you are a participating provider in the Well Sense network and have any questions, please contact the Well Sense provider relations team at NHproviderinfo@wellsense.org or 877-957-1300 option 3.

If you would like to join the Well Sense network, you must first be enrolled in New Hampshire Medicaid. To learn more about enrolling, visit Well Sense’s enrollment web page. Once you are enrolled in New Hampshire Medicaid, please call (800) 708-4414.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator