Blue Cross Blue Shield of Massachusetts

Prior authorization

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

prior authorization

Medical pre-authorizations and referrals — commercial

Official page read
Phone800-327-6716Published hours

Not published in this record

Product, plan and location

commercial
Massachusetts

Mailing address

Not researched for this route

Commercial members. Excludes chiropractic (WholeHealth Living), genetic testing, high-tech radiology, outpatient cancer care and sleep studies (Carelon). Authorization Manager is the online option.

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Medical pre-authorizations and referrals — FEP members receiving care in Massachusetts

Official page read
Phone800-689-7219Published hours

Not published in this record

Product, plan and location

fehb
Massachusetts

Mailing address

Not researched for this route

Federal Employee Program members getting care in Massachusetts.

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Medical pre-authorizations and referrals — Medicare Advantage

Official page read
Phone800-222-7620Published hours

Not published in this record

Product, plan and location

medicare advantage
Massachusetts

Mailing address

Not researched for this route

Blue Cross Medicare Advantage members. Same carve-outs as commercial (chiropractic, Carelon-managed services).

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Chiropractic authorizations — WholeHealth Living support line

Official page read
Phone866-656-6071Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
Massachusetts

Mailing address

Not researched for this route

WholeHealth Living, Inc. administers chiropractic service authorizations for Blue Cross.

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Carelon Medical Benefits Management — genetic testing, high-tech radiology, outpatient cancer care, sleep

Official page read
Phone866-745-1783Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
Massachusetts

Mailing address

Not researched for this route

When the member plan requires Carelon review. Requests can also be placed through the Carelon Provider Portal (eTools > Carelon on Provider Central).

View source ↗ · Source checked 2026-10-25

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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Call preparation · editorial guide

Make the call count.

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

Have ready in your secure workspace

  • Ordering and rendering provider details
  • Service codes, requested dates and units
  • Existing authorization or submission reference

Questions to resolve

  • Is this the correct reviewer for this service and product?
  • Which documents are missing, and where should they be sent?
  • What is the case number and next status-check date?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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A request does not create an account or start a call. Use business contact information only. No patient information.

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