The NHP forms and applications providers use most:
Credentialing and Enrollment Forms
Neighborhood Health Plan, in conjunction with the Massachusetts Association of Health Plans, the Massachusetts Medical Society and the Massachusetts Hospital Association, has developed the HCAS Provider Enrollment Form—a single, uniform application that facilitates the credentialing process for all physicians practicing in the Commonwealth.
HCAS Provider Enrollment Form (revised March, 2013) - Contracted Providers Only
Providers are encouraged to download it, fill it out, and fax or email it to our Provider Service Center. If you have any questions, please contact NHP’s Provider Service Center:
Phone: 1-855-444-4NHP (4647)
Fax: 617-772-5517 firstname.lastname@example.org
Standardized Provider Information Change Form
To make sure that health plans and their members have the most up-to-date information about your practice, the Mass Collaborative* is pleased to introduce the Standardized Provider Information Change Form. When you are changing your practice name, address, phone numbers, e-mail, billing company, or other practice information, you only need to complete this single form and send it via email, fax, or US mail to each health plan you contract with instead of completing a different form for each health plan. The following health plans now accept this form:
- Blue Cross Blue Shield of Massachusetts
- Boston Medical Center Healthnet Plan
- Celticare Health Plan of Massachusetts
- Fallon Community Health Plan
- Fallon Total Care
- Harvard Pilgrim Health Care
- Health New England
- Neighborhood Health Plan
- Network Health
- Tufts Health Plan
- Senior Whole Health
This form should not be used to submit credentialing or contractual changes. Continue to use individual health plan forms for those changes. In some circumstances, individual health plans may need to follow up with providers for additional information regarding a demographic change.
For questions about specific health plan policies or requirements, contact that health plan directly.
* The Mass Health Collaborative is a multi-stakeholder group committed to reducing health care administrative burdens and costs. Members of the Mass Collaborative include the Massachusetts Hospital Association, Massachusetts Medical Society, Blue Cross Blue Shield of Massachusetts, the Massachusetts Association of Health Plans, the Massachusetts Health Data Consortium, MassHealth, Healthcare Administrative Solutions, as well as many local payers and providers.