Provider Manual
Posted on July 27, 2022
Health New England reviews our provider manual regularly and notifies you when there are updates. Most recently, we updated the Serious Reportable Events and Never Events section, as well as the Professional Credentialing and Re-credentialing section. Go to healthnewengland.org/providers/provider-manual/network-operations.
In the Serious Reportable Events and Never Events section:
- We clarified that a claim may be subject to denial or payment retraction if the claim is identified to have met the requirements for non-reimbursement as a serious reportable event or never event.
- We also noted under the “Reimbursement” section, to reference the guidelines of the Serious Reportable Events / Provider Preventable Conditions Payment Policy.
In the Professional Credentialing and Re-credentialing section:
- All content was reviewed and updated where necessary. For example,
- The table listing who we credential
- Clarification/removal of duplicate information on the board certification requirement
For more information, please call Provider Relations at (800) 842-4464, extension 5000, or send an email to providerrelations@hne.com.
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