ATTENTION SNF/ECFs and FACILITIES: Please include your insurance liability information with your LOI 

Please email, fax or mail us the Letter of Intent (LOI) to: 

Email: pcontracting@hne.com

Fax: 413-233-3175

Mail: 
Health New England
Attn: Provider Contracting
One Monarch Place, Suite 1500
Springfield, MA 01144

We will review your letter and make a decision based on the information you provide and our current needs. The review period for a decision is approximately 6 to 8 weeks from the date the letter was received by Health New England. Once we make a decision, or if we need more information, we will contact you either by phone or mail. If you have any questions, please email Provider Contracting at  pcontracting@hne.com.

Note: Applicable to Medical Providers: If a provider is currently participating with an Individual Practice Association (IPA) or Physician Hospital Organization (PHO) the provider must contact the IPA or PHO to discuss the process to join the HNE network.

Health New England does not require referrals to in-plan specialists. Although Health New England stresses the importance of seeing a primary care provider (PCP) for coordination of care, members can make an appointment with an in-plan specialist without a referral.

Providers can submit professional claims electronically through Health New England’s secure web portal, HNEDirect. The portal is only available for in-plan providers.

Once you register for HNEDirect, you will be able to submit electronic claims directly to Health New England. To register for HNEDirect, or to log in if you already are a user, visit https://www.hnedirect.com/login/index.aspx.

Providers can verify member eligibility through Health New England’s secure web portal, HNEDirect. The portal is only available for in-plan providers. Providers also can verify eligibility by calling our Member Services Department at (800) 310-2835.

To register for HNEDirect, or to log in if you already are a user, visit https://www.hnedirect.com/login/index.aspx.

Providers can make changes to demographics through Health New England’s secure web portal, HNEDirect or by faxing a letter to our Provider Enrollment Department at (413) 233-2665.

Please be sure to specify the effective date of the change.

To register for HNEDirect, or to log in if you already are a user, visit https://www.hnedirect.com/login/index.aspx. The portal is only available for in-plan providers.

Health New England’s service area consists of the four counties of Western Massachusetts (Hampden, Hampshire, Franklin and Berkshire) and parts of Worcester County. Health New England also has providers in Hartford, Litchfield and Tolland counties in northern Connecticut for our self-funded members.

If a member does not have out-of-plan benefits, but needs to see an out-of-plan specialist, the referring in-plan physician must submit a Prior Authorization Request Form (PARF) to our Health Services Department. This is subject to review and would be considered only if the services are not available in-plan. The review process normally takes 24-48 business hours.

Providers have one year from the dates of services to submit an appeal. A provider appeal must be submitted via the Request for Claim Review Form. This form and the Appeal Guidelines can be found at http://healthnewengland.org/forms under the Provider tab or in the Provider Manual at http://healthnewengland.org/provider-manual.

You can notify Health New England of your covering arrangements by faxing a letter detailing the arrangements to our Provider Enrollment Department at (413) 233-2665.

You can check claim status on Health New England’s secure web portal, HNEDirect, or you can call our Provider Claims Queue at (800) 842-4464, press 2, then press 3.

To register for HNEDirect, or to log in if you already are a user, visit https://www.hnedirect.com/login/index.aspx. The portal is only available for in-plan providers.

To notify Health New England of your NPI number, please fax a letter to our Provider Enrollment Department at (413) 233-2665.