Prior authorization to Centene / WellCare

Centene is the largest Medicaid managed care organization in the US, serving members under subsidiaries that include WellCare, Ambetter, Peach State Health Management, Sunshine Health, and others depending on state. PA contact information, fax numbers, and clinical requirements vary by subsidiary and state — a WellCare PA fax number is not valid for an Ambetter plan. Identify the exact plan brand and state on the member's insurance card before starting.

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Centene / WellCare

MedicaidMarketplaceMedicare Advantage

PA Fax: Enter manually
PA Phone: +18667966471
Standard turnaround: 5 business days
Urgent turnaround: 72 hours

PA fax number varies by state subsidiary (WellCare, Ambetter, etc.). Check your plan directory.

Centene / WellCare provider portal →

What you'll need

PhoneFaxPortal

☐Identify the correct subsidiary (WellCare, Ambetter, Peach State, Sunshine Health, etc.)
☐Get the state + subsidiary-specific fax number from the plan directory
☐Patient member ID
☐ICD-10 diagnosis code(s)
☐CPT procedure code(s)
☐Clinical notes and treatment history
☐Ordering provider NPI

▶Common denial reasons

⚠Request sent to wrong subsidiary or wrong state office
⚠State Medicaid plan requirements not met
⚠Missing prior treatment history
⚠Service requires additional state-level approval

Verified 2026-05-20. Check payer site for current rules →

From $2.99 per submission

PA Agent requires an account so you can track submissions, record outcomes (approved/denied), and pre-fill appeals automatically. It's free to join.

You can preview the form below — sign in before generating or submitting.

⬆ Import from CSVDownload template

Submission checklist

○Provider name, NPI, practice name

○Provider phone & fax number

○Patient name, DOB, member ID

○ICD-10, diagnosis, CPT, procedure

○Clinical notes (min 50 chars · 0 entered)

○Fax destination number

○AI justification generated & reviewed

0 of 7 checks complete

Prior Authorization Request

1. Provider Information

Provider Name *

NPI * (10 digits)

Practice Name *

Provider Phone *

Provider Fax *

2. Patient & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

💬 Patient notifications: add the patient's email below and they'll automatically receive an email when you record the insurer's decision on the tracking page — no phone call needed.

Patient Email (for outcome notifications)

Patient Phone (for future SMS notifications)

3. Clinical Details

ICD-10 Code *

Diagnosis Description *

CPT Code * (5 digits)

Procedure Description *

Urgency

4. Clinical Notes

Provider notes & supporting rationale *(min 50 chars)0/10000

5. AI Clinical Justification

PHI notice: Clicking “Generate with AI” sends clinical notes and diagnosis to OpenAI for processing. Do not include information beyond what is clinically necessary. Review your organization's policies before submitting patient data to third-party AI services.

6. Submission Method

PA fax number varies by state subsidiary (WellCare, Ambetter, etc.). Check your plan directory. Find fax number →