WellSense Health Plan

Summary

WellSense Health Plan is a Medicaid managed care organization offering dental, medical, and vision coverage operating in Massachusetts and New Hampshire. Claims route under payer ID 13337, with 12 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through WellSense Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes a few days.

At a glance

Payer ID

13337Also seen as 00074, 100957, 10556, 10814, 13337MA, 2921 and 6 more

Also known as

BMC HealthNet Plan, Boston Medical Center Health Plan, Boston Medical Center HealthNet Plan, Boston Medical Center Healthnet, Well Sense

Uses CAQH

YesApplication route: Payer portal application

Service area

MA, NH

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Common questions

What is the payer ID for WellSense Health Plan?

The payer ID for WellSense Health Plan is 13337. Alternate IDs seen across clearinghouses include 00074, 100957, 10556, 10814.

How long does WellSense Health Plan provider enrollment take?

WellSense Health Plan provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does WellSense Health Plan require CAQH?

Yes. WellSense Health Plan uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does WellSense Health Plan require ERA enrollment?

Yes. WellSense Health Plan requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few days.

What states does WellSense Health Plan cover?

WellSense Health Plan operates in MA, NH. Coverage can differ by plan and product line, so confirm the specific plan before you file.