WellSense provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.wellsense.org/providers |
|---|---|
| Payer contact reference | 1-888-566-0008Massachusetts provider support only |
| Claims payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| ERA payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| Timely filing | Massachusetts: MassHealth 150; Clarity 90 days |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- Massachusetts provider support only
- The Massachusetts source distinguishes MassHealth initial claims at 150 days from Clarity at 90 days. Confirm the applicable contract, network status and start event; other state/product rules require separate review.
- This registry has not established a payer-specific appeal ladder for WellSense. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
WellSense at a glance
| Legal name | WellSense Health Plan |
|---|---|
| Also known as | WellSense Health Plan, BMC HealthNet Plan (legacy) |
| Category | Medicaid MCO |
| Parent organization | WellSense Health Plan (nonprofit, sponsored by Boston Medical Center) |
| Claims payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | Massachusetts, New Hampshire |
| Members covered | ~500k members |
| Provider resource entry point | https://www.wellsense.org/providers |
| Provider phone | 1-888-566-0008Massachusetts provider support only |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for WellSense
The Massachusetts source distinguishes MassHealth initial claims at 150 days from Clarity at 90 days. Confirm the applicable contract, network status and start event; other state/product rules require separate review.
| Submission type | Window |
|---|---|
| Initial claim reference | Massachusetts: MassHealth 150; Clarity 90 days |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for WellSense. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: WellSense provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with WellSense
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify WellSense electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for WellSense. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for WellSense
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient WellSense volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | 13337 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 13337 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
timely_filing_days
Source comparison: 2026-09-26
Current Massachusetts HTML specifies 150 days for MassHealth and 90 days for Massachusetts Clarity. Baseline 150 is supportable only for the MassHealth scope; nonparticipating providers have separate guidance.
Primary source for timely_filing_daysprovider_phone
Source comparison: 2026-09-26
Contact table identifies 888-566-0008 as Massachusetts provider support. New Hampshire Medicaid, Clarity and Medicare Advantage use distinct contacts.
Primary source for provider_phoneportal_url
Source comparison: 2026-09-26
Official login page separates the provider portal from member and broker accounts; provider claims page confirms electronic submission and status functions.
Primary source for portal_urlelectronic_claims_supported
Source comparison: 2026-09-26
Massachusetts claims page supports direct portal or clearinghouse submission and specifies corrected-claim 837 handling.
Primary source for electronic_claims_supported
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids / era_payer_id / supports_279_271 / supports_278: Reviewed HTML does not establish identical 13337 routing across transactions or X12 270/271 and 278 transport. Online eligibility/authorization functions alone do not establish those transaction flags..
Sources used for this guide
State coverage
WellSense operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for WellSense
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for WellSense; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for WellSense; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for WellSense before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about WellSense
Where is the WellSense provider portal?
Use https://www.wellsense.org/providers as a starting point for WellSense provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for WellSense?
The Massachusetts source distinguishes MassHealth initial claims at 150 days from Clarity at 90 days. Confirm the applicable contract, network status and start event; other state/product rules require separate review.
What is the WellSense payer ID?
Claims: 13337 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): 13337 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 13337 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does WellSense accept electronic claims?
Verify WellSense electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a WellSense denial?
This registry has not established a payer-specific appeal ladder for WellSense. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do WellSense prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the WellSense provider phone number?
This registry lists 1-888-566-0008 as a contact reference for WellSense. Massachusetts provider support only
Automate workflows around WellSense requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against WellSense's current published documents before submission. CPT® is a registered trademark of the American Medical Association.