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PA Health & Wellness, Inc. fax number

(866) 528-9908

Program Coordination (CHC Provider Coordination)

Used for: Submission of the MA570 Physician Certification Form for Pennsylvania Community HealthChoices/Medical Assistance renewals

Fax destination details

Department
Program Coordination (CHC Provider Coordination)
Purpose
Submission of the MA570 Physician Certification Form for Pennsylvania Community HealthChoices/Medical Assistance renewals
Form
MA 570 — Physician Certification Form MA 570
Address
300 Corporate Center Dr, Ste 600, Camp Hill, PA 17011, USA
Voice phone
1-844-626-6813

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Complete the MA 570 Physician Certification Form and return it to PA Health & Wellness upon physician review; submit via fax to 866-528-9908 or email to Program_Coordination@PaHealthWellness.com.

Official form instructions are published as a downloadable file on the organization's website.

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