PRovider Manual

The Health New England (HNE) Provider Manual contains information, guidelines, and procedures that should be followed when rendering medical service to members and which are common to managed care in general. This edition of the HNE Provider Manual supersedes all previous editions. It includes information and changes for which providers have received written notification throughout the past year. Any additional material changes for which notification has not been provided will take effect 60 days from the distribution of this Manual. This edition of the Manual may also be found on the HNE secure website at  HNEDirect.

Some of the guidelines and procedures in this Manual are based on requirements of State and Federal law as well as accrediting organizations. Thus the guidelines and procedures are subject to change if the requirements of the law or accrediting organizations change. HNE will notify providers in writing of modifications to this Manual that have a substantial impact on provider rights or responsibilities at least 60 days prior to the effective date of such modifications. Where there is a conflict between this edition of the Manual and a subsequent notification of a modification to a policy or procedure, the information in the subsequent notification shall prevail.

If providers have questions or recommendations about the information in this Provider Manual, they should contact Provider Relations at (800) 842-4464 ext. 5000. Representatives are available Monday-Friday from 8:00 am to 4:00 pm.

Full Provider Manual (PDF)

Medicare Amendment to the HNE Provider Manual (PDF)
HNE BeHealthy Addendum to the HNE Provider Manual (pdf)
HNE HEDIS Chart Addendum to the HNE Provider Manual (pdf)