NEHENnet
NEHENnet provides RCM/Clearinghouse services
NEHENnet provides RCM/Clearinghouse services using the TriZetto Provider Solutions engine. Accessing this environment through NEHEN provides
- One fixed flat fee per month, paid quarterly to help you manage cash flows
- No hidden costs or fees
- No long term contracts. (60 day notification for cancellation of all services)
- No special software required, all you need is a computer with Web browser and internet connection
- Includes free training and technical support
- Complete Revenue Cycle access across the majority of regional payers including Medicare and Medicaid (See Below Grid)
- Submit a single real-time eligibility inquiry to multiple payers [D] at once
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:
- One fixed flat fee per month, paid quarterly to help you manage cash flows
- No hidden costs or fees
- No long term contracts. (60 day notification for cancellation of all services)
- No special software required, all you need is a computer with Web browser and internet connection
- Includes free training and technical support
- Complete Revenue Cycle access across about 20 different payers including Medicare and Medicaid (See Below Grid)
- Submit a single real-time eligibility inquiry to multiple payers [D] at once
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($$) | ✓ | ✓ |
- ✓ – Included in the fixed monthly subscription
- ✓ 1($) –$0.05 per transaction
- ✓ 2($$) –$0.40 per transaction
- [D] – Payers participating in real-time Discovery Inquiries
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
- $0.045/trx – Eligibility (270/271)
- $0.045/trx – CSI (276/277)
- $0.40/trx – Specialist Referrals (278)
- $0.10/trx – Claim Submission (837). Corresponding Claim Remittance (835) will be free for claims submitted.
- $0.05/trx – Standalone Claim Remittance (835)
Not sure? We do offer a no-obligation 30 day trial to try out the Eligibility portion of NEHENnet for one NPI.