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WellSense Health Plan fax number
(857) 264-2673
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Behavioral Health / Utilization Management (Provider Relations)
Used for: Prior authorization for behavioral health services (e.g., Applied Behavioral Analysis) and behavioral health admission/notification forms; provider PA submissions.
Fax destination details
- Department
- Behavioral Health / Utilization Management (Provider Relations)
- Purpose
- Prior authorization for behavioral health services (e.g., Applied Behavioral Analysis) and behavioral health admission/notification forms; provider PA submissions.
- Form
- Prior Authorization Form — Applied Behavioral Analysis Prior Authorization Form (MassHealth) – WellSense MA plans
- Address
- WellSense Health Plan, 100 City Square, Suite 200, Charlestown, MA 02129
- Voice phone
- 888-566-0010
- Website
- Visit organization website
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- Confirm that this exact department handles your document or request.
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For initial requests, services may be requested for a 3-month timeframe; for continued services, a 6-month timeframe; the Board-Certified Behavior Analyst (BCBA) must complete the form and include supporting documentation (e.g., IEP or diagnostic evaluation).
Official form instructions are published as a downloadable file on the organization's website.
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