WellSense Health Plan

Prior authorization

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

fax prior auth

Massachusetts prior authorization — new requests fax

Official page read
Phone

No phone listed for this route

Fax

617-951-3464

New medical prior authorization requests (MA).

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
Massachusetts

Mailing address

Not researched for this route

Portal (HealthTrio) is preferred; fax results in longer processing. Additional clinical information for Massachusetts requests: 617-951-3461.

fax prior auth

Massachusetts prior authorization — additional clinical fax

Official page read
Phone

No phone listed for this route

Fax

617-951-3461

Additional clinicals for MA PA requests.

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
Massachusetts

Mailing address

Not researched for this route

Additional clinical documentation for pending Massachusetts PA requests.

View source ↗ · Source checked 2026-10-25

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fax prior auth

Massachusetts inpatient admissions notification fax

Official page read
Phone

No phone listed for this route

Fax

617-951-3463

Inpatient admission notifications (MA).

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
Massachusetts

Mailing address

Not researched for this route

Inpatient admission notifications for Massachusetts members. Inpatient clinical documentation: 617-897-0892.

View source ↗ · Source checked 2026-10-25

Report an update

fax prior auth

Massachusetts inpatient clinical fax

Official page read
Phone

No phone listed for this route

Fax

617-897-0892

Inpatient clinical documentation (MA).

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
Massachusetts

Mailing address

Not researched for this route

Inpatient clinical reviews for Massachusetts members.

View source ↗ · Source checked 2026-10-25

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prior authorization

eviCore — genetic testing, MSK and high-tech imaging (MA)

Official page read
Phone877-512-5985Fax

833-812-0687

eviCore authorization requests.

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
Massachusetts

Mailing address

Not researched for this route

Per the WellSense prior authorization page. The Massachusetts quick reference guide (8/2026) still shows older eviCore numbers; this page is used.

View source ↗ · Source checked 2026-10-25

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

prior authorization

eviCore — genetic testing, MSK and high-tech imaging (NH)

Official page read
Phone866-716-8338Fax

833-812-0687

eviCore authorization requests.

Published hours

Not published in this record

Product, plan and location

medicaid · exchange · medicare advantage
New Hampshire

Mailing address

Not researched for this route

New Hampshire members; eviCore manages these services for WellSense.

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

Durable medical equipment — Northwood, Inc.

Official page read
Phone866-802-6471Fax

877-552-6551

DME authorization requests.

Published hours

Not published in this record

Product, plan and location

medicaid · exchange · medicare advantage
Massachusetts · New Hampshire

Mailing address

Not researched for this route

Northwood manages DME prior authorizations for WellSense; home infusion therapy goes through the WellSense portal instead.

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

fax prior auth

New Hampshire Medicaid and Clarity prior authorization — new requests fax

Official page read
Phone

No phone listed for this route

Fax

603-218-6634

New PA requests (NH Medicaid/Clarity).

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
New Hampshire

Mailing address

Not researched for this route

Additional clinical: 603-218-6667. NH consent forms: 603-218-6725. NH Medicare Advantage uses a different fax (the guide shows two variants, so it is withheld).

fax prior auth

New Hampshire Medicaid and Clarity inpatient admissions fax

Official page read
Phone

No phone listed for this route

Fax

866-813-8607

Inpatient notifications (NH).

Published hours

Not published in this record

Product, plan and location

medicaid · exchange
New Hampshire

Mailing address

Not researched for this route

Inpatient admission and emergent admission/observation notifications. Additional inpatient clinical: 866-837-5725.

View source ↗ · Source checked 2026-10-25

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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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For the people making the calls

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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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