Implementing NEHEN has changed the way administrative processes are done in member organizations. Today, NEHEN participants already transmit all HIPAA Administrative Transactions such as:

  • Eligibility Verification
  • Specialty Care Referrals
  • Authorization / Pre-Certification
  • Referral Inquiry
  • Claim Status Inquiry
  • Claim Submission
  • Electronic Remittance

NEHEN's membership includes leading regional payers such as Blue Cross Blue Shield, Harvard Pilgrim Health Care, MassHealth, Neighborhood Health Plan, Network Health and Tufts Health Plan. NEHEN also has connectivity to MA Medicare including national payers such as Aetna and Cigna.