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Become a Provider

Thank you for your interest in participating with NH Healthy Families. We are excited that you selected our provider network as your network of choice.  Below are the steps required to join our Provider Network.

Fields denoted with an asterisk (*) are required.

Update an Existing Contract

To add additional services or to make changes to an existing contract, email NH_ProviderNetworkOperations@centene.com.

Update a Medical Practitioner or Practice

To make updates to your billing address, practice location (move or add), office hours, specialty, or services, please do the following:

  1. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Provider Change Form.
  2. Complete, sign, and date a W9 Form (PDF).
  3. Complete a Provider Change Form (PDF).
  4. Submit your completed forms to our contracted provider document upload form.

Update a Behavioral Health Practitioner or Practice

To make updates to your billing address, practice location (move or add), office hours, specialty, or services, please do the following:

  1. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Provider Change Form.
  2. Complete, sign, and date a W9 Form (PDF).
  3. Complete a Provider Change Form (PDF).
  4. Submit your completed forms to our contracted provider document upload form.

Update a Dual Practitioner or Practice

To make updates to your billing address, practice location (move or add), office hours, specialty, or services, please do the following:

  1. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Provider Change Form.
  2. Complete, sign, and date a W9 Form (PDF).
  3. Complete a Provider Change Form (PDF).
  4. Submit your completed forms to our contracted provider document upload form.

Enroll a New Medical Practioner

To submit a new medical enrollment please do the following:

  1. Attest on CAQH (except hospitalists) and ensure all required documents are uploaded.
  2. Authorize NH Healthy Families in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete a CAQH Form (PDF) or Enrollment Roster (PDF) for more than 10 practitioners.
  5. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  6. Submit your completed forms to our contracted provider document upload form.

Enroll a New Behavioral Health Practitioner

To submit a new behavioral health/substance use disorder enrollment please do the following:

  1. Attest on CAQH and ensure all required documents are uploaded.
  2. Authorize NH Healthy Familes in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete Provider Specialty Profile Form (PDF) (for 9 or fewer practitioners) or an updated Enrollment Roster (PDF) (for 10 or more practitioners).
  5. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  6. Submit your completed forms to our contracted provider document upload form.

Enroll a New Dual Health Practitioner

To submit a new dual enrollment please do the following:

  1. Attest on CAQH (except hospitalists) and ensure all required documents are uploaded.
  2. Authorize NH Healthy Familes in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete a Provider Specialty Profile Form (PDF).
  5. Complete a CAQH Form (PDF) or Enrollment Roster (PDF) for more than 10 practitioners.
  6. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  7. Submit your completed forms to our contracted provider document upload form.

Submit a New Medical Contract Request

To submit a new medical contract request, please do the following:

  1. Attest on CAQH (except hospitalists) and ensure all required documents are uploaded.
  2. Authorize NH Healthy Families in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete, sign, and date a W9 Form (PDF).
  5. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  6. Complete the Join Our Network request.

Submit a New Behavioral Health Contract Request

To submit a new behavioral health contract request, please do the following:

  1. Attest on CAQH and ensure all required documents are uploaded.
  2. Authorize NH Healthy Families in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete, sign, and date a W9 Form (PDF).
  5. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  6. Complete the Join Our Network request.

Submit a New Dual Contract Request

To submit a new dual enrollment, please do the following:

  1. Attest on CAQH (except hospitalists) and ensure all required documents are uploaded.
  2. Authorize NH Healthy Families in CAQH.
  3. Go to NPPES and ensure your name, taxonomy, and all other information is correct and matches your submitted Enrollment Request.
  4. Complete, sign, and date a W9 Form (PDF).
  5. Ensure you have a NH Medicaid ID or apply for a NH Medicaid ID.
  6. Complete the Join Our Network request.

Ambetter

For more information on becoming an Ambetter provider, please visit our Ambetter website.