NEHENnet

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NEHENnet provides RCM/Clearinghouse services

NEHENnet provides RCM/Clearinghouse services using the TriZetto Provider Solutions engine. Accessing this environment through NEHEN provides

Accessing majority of Regional and National Payers in One Solution for Revenue Cycle Management

Payer Name

270/271

eligibility

2766/277

csi

278

specialist

referrals

837

claim

submission

835

claim

remittance

BCBS MA

D

Blue Benefit Administrators

Boston Medical Center Health Plan

D

Commonwealth Care Alliance

Fallon

D

Harvard Pilgrim Health Care

D

Health New England

D

Allways Health Partners (NHP)

D

Tufts Health Plan

D

Tufts Network Health

D

Aetna

D

✓2($$)

Cigna

D

✓2($$)

Connecticare



MA Medicaid

D

Medicare

Oxford

D

✓2($$)

Tricare

✓1($)

Unicare

✓2($$)

United Healthcare Student Resources

United Healthcare

D

✓2($$)

legend:
P         
P1 ($)   
P2 ($) 
[D] 
– Included in the fixed monthly subscription cost
– $0.05 per transaction
– $0.40 per transaction
– Payers participating in real-time Discovery inquiries
legend:

Non-NEHENnet Participating Additional Payers can be added from Trizetto Provider Solutions (TPS) from a list of over 8,000+ national and regional payers for incremental per-transaction fees.

Payer Name

270/271

eligibility

2766/277

csi

278

specialist

referrals

837

claim

submission

835

claim

remittance

BCBS MA

D

Blue Benefit Administrators

Boston Medical Center Health Plan

D

Commonwealth Care Alliance

Fallon

D

Harvard Pilgrim Health Care

D

Health New England

D

Allways Health Partners (NHP)

D

Tufts Health Plan

D

Tufts Network Health

D

Aetna

D

✓2($$)

Cigna

D

✓2($$)

Connecticare



MA Medicaid

D

Medicare

Oxford

D

✓2($$)

Tricare

✓1($)

Unicare

✓2($$)

United Healthcare Student Resources

United Healthcare

D

✓2($$)

legend:
P – Included in the fixed monthly subscription cost
P1 ($) – $0.05 per transaction
P2 ($) – $0.40 per transaction
[D] – Payers participating in real-time Discovery inquiries. 
legend:

Non-NEHENnet Participating Additional Payers can be added from Trizetto Provider Solutions (TPS) from a list of over 8,000+ national and regional payers for incremental per-transaction fees.

Accessing this environment through NEHEN provides:

Picture of a nurse holding a clipboard in a busy hospital
Payer Name
270/271 Eligibility
276/277 CSI
278 Special List REferrals
837 Claim Submission
835 Claim Remittance
BCBS MA
Blue Benefit Administrators
Boston Medical Center Health Plan
Commonwealth Care Alliance
Fallon
Harvard Pilgrim
Health New England
Allways Health Partners (NHP)
Tuffs Health Plan
Tufts Network Health
Aetna
2($$)
Celticare
2($$)
Cigna
2($$)
Connecticare
2($$)
MA Medicaid
Medicare
Oxford
2($$)
Tricare
1($)
2($$)
Unicare
2($$)
United Healthcare Student Resources
2($$)
United Health Care
2($$)

Additional Payers not participating above can be made available upon request.  Transactions charges which our platform is assessed will be directly passed on at the following rates

Not sure? We do offer a no-obligation 30 day trial to try out the Eligibility portion of NEHENnet for one NPI.