Credentialing in New Hampshire

NH Medicaid (NH DHHS) provider enrollment runs on the NH MMIS Health Enterprise Portal (nhmmis.nh.gov), which self-identifies as "the Conduent Government Solutions Health Enterprise Portal." Application types are Billing Provider (group FEIN or individual SSN), Non-Billing (ordering/referring or rendering. Every rendering provider in a group must individually enroll and be affiliated), and Trading Partners.

NH MMIS Health Enterprise Portal · checked Jul 2026

Most NH Medicaid members are in Medicaid Care Management (MCM) with one of three MCOs: AmeriHealth Caritas New Hampshire, NH Healthy Families (Centene), and WellSense Health Plan. Long-term-care/waiver services stay in the regular Medicaid (FFS) program.

NH DHHS, Medicaid Care Management · checked Jul 2026

RSA 420-J:4(I)(h) requires a health carrier to "Act upon and finalize the credentialing process within 30 calendar days of receipt of a clean and complete application for primary care physicians and mental health providers and within 45 days of receipt of a clean and complete application for specialists," with incomplete-application notice due "not later than 15 business days." The statute was amended effective Jan. 1, 2026 and the 30/45-day clause survives. A 30-day clock covering mental-health providers by name is rare; hold NH plans to it.

NH RSA 420-J:4, Credentialing Verification Procedures · checked Jul 2026

While an application is pending, RSA 420-J:4(I)(b)(1)-(2) lets an applicant who is already licensed and hospital-credentialed cover on-call, and lets a provider credentialed by the same carrier in another state (or in-network via an employer entity) deliver services before credentialing completes. Re-verification is triennial under paragraph III.

NH RSA 420-J:4, Credentialing Verification Procedures · checked Jul 2026

Post-master's counselor/MFT candidates have no individual Medicaid enrollment door in NH. They render inside an He-M 403-approved community mental health program (CMHP) that bills, under He-M 426.08's supervised lane: a master's degree in marriage and family therapy, psychology, social work, rehabilitation counseling, or education/counseling, at least one year of supervised work in the field, and "ongoing supervision of at least 2 hours per month" (at least 1 hour per month direct by a licensed practitioner of the healing arts). For enrolled master's/doctoral interns, "The medicaid program shall reimburse CMHPs and community mental health providers only when supervision occurs and is documented."

NH He-M 400 administrative rules (He-M 426.08) · checked Jul 2026

BH licensure sits under NH's consolidated Office of Professional Licensure and Certification (OPLC). The Board of Mental Health Practice regulates seven license classes: Clinical Mental Health Counselors, Clinical Social Workers, Marriage and Family Therapists, Pastoral Psychotherapists, School Social Workers, Social Workers, and Social Work Associates.

NH OPLC, Board of Mental Health Practice · checked Jul 2026

New Hampshire is a Counseling Compact member (on the counselingcompact.gov jurisdictions list) but was not among issuing states as of July 2026.

Counseling Compact, Compact Jurisdictions · checked Jul 2026

"There is no standard timeline for application processing under NH Medicaid (Fee-for-Service)." FFS is also contract-free: "There is no contracting process, the rates come from the public NH Medicaid Fee Schedule." File the NH MMIS application on day one. The state provider ID is the critical path.

NH Medicaid Provider Enrollment Overview Guide (rev. 9/01/2023) · checked Jul 2026

New Hampshire's Licensed Social Work Associate (RSA 330-A:18-c, added 2021, amended effective 2025-07-13) has a scope of "the screening, assessment, treatment planning, and treatment of mental health conditions under clinical supervision." It is a bachelor's/associate's-degree track (4,000/6,000 supervised hours), not a post-master's pre-LICSW candidate tier. The LCMHC and MFT ladders have no associate/candidate class at all.

NH RSA 330-A:18-c, Licensed Social Work Associate · checked Jul 2026

WellSense's 2026 NH provider manual §3.3 credentials only "practitioners who have an independent relationship with us and are permitted to practice independently under New Hampshire law," and §3.11 adds that "Behavioral Health credentialed facilities are responsible for credentialing and overseeing its clinical staff. Master's-level behavioral health counselors are approved to function in all contracted hospital-based, agency/clinic-based and other facility sites." Supervision-bound license tiers cannot panel individually.

WellSense Health Plan, NH Provider Manual 2026 · checked Jul 2026

The Medicaid MCO contracts mirror the state statute: "For PCPs, within thirty (30) calendar days of receipt of clean and complete credentialing applications; and For specialty care providers, within forty-five (45) calendar days," plus 10 business days to act on new/missing information. Contracting is not deadline-bound, "the Department does not dictate a timeline for completion of a contract agreement", so slow rate negotiation, not credentialing, is where NH go-lives stall.

NH Medicaid Provider Enrollment Overview Guide (rev. 9/01/2023) · checked Jul 2026

Providers "must first enroll with the state, then enroll (contract and credential) with the MCOs," and "may begin the process of enrolling with any/all of the MCOs before the NH Medicaid application is approved, but will not be able to complete their application until the NH Medicaid provider ID is issued by NH Medicaid (Fee-for-Service)." "Each health plan utilizes CAQH to process provider credentialing applications."

NH Medicaid Provider Enrollment Overview Guide (rev. 9/01/2023) · checked Jul 2026