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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 $1.99 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.

Submission checklist

○Your name, date of birth, member ID

○Your situation described (min 50 chars · 0 entered)

○Insurer fax number

○AI appeal letter generated & reviewed

0 of 4 checks complete

Prior Authorization Request

1. Your Doctor's Information(optional — helps strengthen your appeal)

Doctor Name

NPI (10 digits)

Practice / Clinic Name

Doctor Phone

Doctor Fax

2. Your Information & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

3. Clinical Details(optional — include if known)

ICD-10 Code (if known)

Diagnosis (if known)

CPT Code (if known)

Denied Treatment / Procedure

Urgency

4. Your Medical Situation

Describe your situation in your own words *(min 50 chars)0/10000

Explain why you need this treatment, what your doctor has recommended, and what happened when the insurer denied it. The more detail you provide, the stronger your appeal.

5. AI Appeal Letter

Privacy notice: Clicking “Generate with AI” sends your description to OpenAI to draft your appeal letter. Do not include sensitive information beyond what is medically relevant.

6. Submission Method

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