DialClerk Directory

Harvard Pilgrim Health Care (Point32Health)

Prior authorization

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

fax prior auth

UM fax: inpatient/outpatient/behavioral health

Official page read
Phone

No phone listed for this route

Fax

800-232-0816

Published hours

Not published in this record

Product, plan and location

commercial
Massachusetts · New Hampshire · Maine · Connecticut

Mailing address

Not researched for this route

5/2026 Point32Health chart. Portal (HPHConnect) preferred.

View source ↗ · Source checked 2026-10-20

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prior authorization

Harvard Pilgrim — Evolent utilization management

Official page read
Phone800-642-7543Published hours

Not published in this record

Product, plan and location

commercial

Mailing address

Not researched for this route

Use the service-specific Evolent utilization review criteria and RadMD. The program includes imaging, spine/joint surgery, sleep and specified cardiac services; no 24/7 staffed-phone claim is made. Confirm the exact member plan and service area; this source does not establish a state coverage list.

View source ↗ · Source checked 2026-10-22

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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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