DialClerk Directory

Health plans and insurers

Fallon Health

Phone, published email, fax, addresses and the next step for your office.

6 contact routesNo directory research calls placed

provider services

Provider Service Line

Official page read
Phone866-275-3247Published hours

Not published in this record

Product, plan and location

commercial
Massachusetts

Mailing address

Not researched for this route

Menu guidance in the source record

Press 2 member claim; option 6 EDI; contracts for fee schedule questions

Menus can change. No live call verification is claimed.

View source ↗ · Source checked 2026-10-20

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

fax appeals

Request for Claim Review (appeals/adjustment) fax

Official page read
Phone

No phone listed for this route

Fax

508-368-9890

Published hours

Not published in this record

Product, plan and location

commercial
Massachusetts

Mailing address

Not researched for this route

Page says forms may be faxed to this number; claims appeals coordinator.

View source ↗ · Source checked 2026-10-20

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fax prior auth

ProAuth / Care Services authorization help — fax when instructed

Official page read
Phone866-275-3247Fax

508-368-9700

Prior-authorization requests when instructed to fax; supporting documentation for a pended authorization when portal attachments are blocked, with the authorization number referenced.

Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
Massachusetts

Mailing address

Not researched for this route

Menu guidance in the source record

For help submitting authorizations or using ProAuth: prompt 7, then prompt 2.

Menus can change. No live call verification is claimed.

ProAuth is the preferred submission method. The March 14, 2026 training deck says to use 508-368-9700 if instructed to fax a request. The FAQ also identifies it for supporting documents when portal attachments are blocked. Inpatient notifications, facility levels of care and delegated services have different instructions. The inherited urgent-care fax was not reverified and is omitted.

View source ↗ · Source checked 2026-10-22 · fallon current proauth training ↗ · fallon current training index ↗

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

pharmacy prior auth

Fallon commercial and Community Care — OptumRx pharmacy PA

Official page read
Phone844-720-0035Fax

844-403-1029

Massachusetts Fallon commercial/Community Care pharmacy-benefit prior authorization, using the designated form.

Published hours

Not published in this record

Product, plan and location

commercial
Massachusetts

Mailing address
Optum Prior Authorization Department, PO Box 2975, Mission, KS 66201

Plan-specific pharmacy prior authorization correspondence.

Match the member plan to the current Fallon table. Massachusetts is explicitly excepted in the current Optum notice retiring most PA faxes. The notice gives no retirement date; this record does not treat this fax as a nationwide Optum route. Medical-benefit drugs have a separate Prime Therapeutics route.

View source ↗ · Source checked 2026-10-22 · optum pa guidelines shared current ↗

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

pharmacy prior auth

Fallon MassHealth ACO plans — OptumRx pharmacy PA

Official page read
Phone844-720-0033Fax

844-403-1029

Massachusetts Fallon Medicaid/MassHealth ACO pharmacy prior authorization.

Published hours

Not published in this record

Product, plan and location

medicaid
Massachusetts

Mailing address

Not researched for this route

Use the MassHealth form identified by the plan. Massachusetts is expressly excepted from the current general Optum PA fax-retirement notice; the notice gives no effective date.

View source ↗ · Source checked 2026-10-22 · optum pa guidelines shared current ↗

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

pharmacy prior auth

Fallon — Prime Therapeutics medical-benefit drug authorization

Official page read
Phone800-424-1740Fax

888-656-6671

Medical-benefit, physician-administered drug prior authorization, including home infusion.

Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
Massachusetts

Mailing address

Not researched for this route

Plan page identifies Prime for medical-benefit drugs across its lines of business; pharmacy-benefit requests use separate Optum plan-specific routes.

View source ↗ · Source checked 2026-10-22

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

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