Prior authorizations & referrals

Use our provider portal to submit prior authorization requests. NEW! Immediate approvals for covered, medically necessary outpatient services.

Instructions for submitting authorizations on our provider portal:

• Home Health Care
• Inpatient
• Outpatient
• Referrals
• Fax Coversheet

 

Prior authorization reference guide for limited network products

Our prior authorization processes are slightly different for providers who are contracted with AllWays Health Partners but not participating in one or more of our limited network products. This PDF will help direct you to submit requests to the appropriate location.

Providers who are not contracted directly with AllWays Health Partners can now submit medical authorization requests online through this authorization request form. This includes:

• Aetna Signature Administrators network providers
• MultiPlan PHCS network providers
• Out-of-network providers

 

• Enter a code to check standard prior authorization requirements
• Log into the provider portal for member-specific information
• View a PDF of all services that require referrals, authorizations, or notifications
• View a PDF of durable medical equipment, medical supplies, oxygen related equipment, orthotics prosthetics and hearing aids that require prior authorization

Provider Service for Massachusetts General Brigham employee plans: 844-451-3520

Provider Service for all other plans: 844-451-3518

Visit the Optum Provider Express Portal for more information and to submit prior authorization requests.

The medical specialty drugs on this list require prior authorization through NovoLogix. 
Submit all other medical specialty drug requests through AllWays Health Partners.

Online
Beginning 2/13/20, medical specialty drugs (except for dual benefit medications) can be submitted online. Submit your request through the NovoLogix online prior authorization tool for the fastest processing. You can access the NovoLogix online prior authorization tool through the provider portal.
 
Training video
User guide
 
 
Fax/Phone
 
For all medical specialty drugs, you can use the MA Standardized Prior Authorization form to submit your request to NovoLogix via fax at 844-851-0882.
 
NovoLogix customer service: 844-345-2803
 

For more information, visit our medical specialty drug page.

CVS Caremark manages pharmacy benefits for AllWays Health Partners plans with prescription drug coverage. For the fastest service, please call the dedicated customer service line for your patients' plan or product.

Partners HealthCare Employee Plan Requests
800-364-6331

Specialty Drug Requests (All Other Plans)

Phone: 866-814-5506
Fax: 866-249-6155

 

Non-Specialty Drug Requests

Commercial Plans
Phone: 800-294-5979
Fax: 888-836-0730

 

Health Connector Plans
Phone: 855-582-2022
Fax: 855-245-2134

 

My Care Family
Phone: 877-433-7643
Fax: 866-255-7569

Provider Service: 866-827-5861

Visit the CareCentrix portal for more information and to submit prior authorization requests.

High-Tech Radiology, Select Cardiac Imaging and Diagnostic Services, Molecular and Genetic Testing

Provider Service: 888-693-3211

Visit the dedicated AllWays Health Partners resource page on the EviCore website 

Use the eviCore Provider Portal to submit prior authorization requests

View eviCore updates and other upcoming prior authorization enhancements