How do I become an HNE provider?

If you would like to come on as an in-plan provider with Health New England, you can start with a letter of interest being e-mailed or sent to:

It can also be faxed to: 413-734-3356/Attention Provider Contracting.

Please include in your letter your specialty, the age groups you work with or do not work with, the exact location of your practice, your hours of availability, and any other information you feel would be helpful in reaching an informed decision.  Your request will be reviewed as to the needs of our members and you will hear back from us in two to four weeks.  If you have any questions please feel free to send an email or call Roberta Fitzgerald at 413-233-3580.

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Does HNE require referrals? 

HNE does not require referrals to in-plan specialists.  Although HNE stresses the importance of seeing a Primary Care Physician for coordination of care, members can make an appointment with an in-plan specialist without a referral.

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Can I submit my claims electronically? 

Providers can submit claims electronically through HNE’s secure web portal, HNEDirect.  Once you register for HNEDirect, you will be able to submit E-claims directly to HNE.  If you have questions regarding file transfer options, please contact Provider Relations at 413-233-3313 or toll-free at 800-842-4464, extension 5000.

To sign up for HNEDirect, or to log-in if you already are a user, click here: https://www.hnedirect.com/login/index.aspx

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How do I verify member eligibility?

Providers can verify eligibility through HNE’s secure web portal, HNEDirect.  Providers also can verify eligibility with our Member Services Department at 1-800-310-2835.

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

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How do I make changes to my mailing address, etc.? 

Providers can make changes to their demographics through HNE’s secure web portal, HNEDirect or by faxing a letter to our Provider Enrollment Department at 413-233-2665. Please specify the effective date of the change.

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

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What is your HNE service area? 

HNE’s service area consists of the four counties of Western Massachusetts (Hampden, Hampshire, Franklin and Berkshire); part of Worcester County. HNE also has providers in Hartford, Litchfield, and Tolland Counties in northern Connecticut.

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What is the process of sending an HNE member to a non-HNE provider?

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.

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How do I appeal a claim?

Providers have one year from the dates of services to submit an appeal.  A Provider Appeal must be submitted on the Provider Appeal Review Sheet.  This sheet and the Appeal Guidelines can be found under Provider Forms on hne.com (click here) or in the HNE Provider Manual.

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How do I notify you of my covering arrangements? 

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

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How do I question a claim status?

You can check claim status on HNE’s secure web portal, HNEDirect, or you can call our Provider Claims Queue at 800-842-4464, press 4, then press 2.

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

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How do I notify you of my NPI number? 

To notify HNE of your NPI number, please fax a letter to our Provider Enrollment Department at 413-233-2665.

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