DialClerk Directory

Fallon Health

Pharmacy and drug authorizations

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

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 ↗

Report an update
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.

Help the next office

How did your call go?

Share a structured call experience or flag a contact correction. Submissions are reviewed before publication. Patient details, recordings and documents do not belong here.

Share a call experience

Share a call experience

Suggest a contact correction

Suggest a correction

Call preparation · editorial guide

Make the call count.

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

Have ready in your secure workspace

  • PBM name and the pharmacy identifiers on the card
  • Drug, formulation and prescription information
  • Prescriber details and previous review reference

Questions to resolve

  • Is this processed under the medical or pharmacy benefit?
  • What is the correct review and submission channel?
  • Is there a separate specialty pharmacy or appeal team?

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

For healthcare offices

Found the contact. Still need to make the call?

Explore how DialClerk organizes the brief, hold time and staff handoff for your next administrative call.

For the people making the calls

Put payer follow-up
on your office’s worklist.

Explore DialClerk for queued calls, hold handling, staff handoffs and a record of the next step. Tell us how your team works.

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

See how it could work for your practice