Web(MASSHEALTH USE 0NLY) 29. Receipt Date 30. Deferral Date 31. Date Info Received / / / / / / 32. Authorized Effective Date 33. Authorized End Date 34. Decision Date / / / / / / 35. Consultant Initials 36. Consultant ID 37. Tracking Number. 38. PA Number Please see reverse side for instructions. SERVICES REQUESTED MEMBER INFORMATION … WebThe Member Services team is here for you. Call 1-855-860-4949. Our Nurse Advice Line is open 24/7. Call 1-855-300-6915. Be ready to give your name, member ID number, and symptoms. Behavioral health support is a part of your health plan. Call 1-855-860-4949 to learn more. More.
MassHealth Drug List - Health and Human Services
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Provider Resources Massachusetts WellSense Health Plan
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