Key Contact Information
Commonwealth Care Alliance

Provider Manual

As part of our commitment to supporting our provider partners, we have created this resource to offer you comprehensive information about our plans.

In addition to detailed program information, you will find our policies and procedures, referral and claim information, and other useful reference materials that we hope will make working with our staff and members as simple as possible.

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Provider Manual

Section 1: Key Contact Information



Telephone & Fax

Web / E-mail

Claims Office
P.O. Box 22280
Portsmouth, NH 03802-2280
Tel: 800-306-0732 ----
TTY Massachusetts Relay Service Tel: 800-439-2370
(TTY 711)


Refunds and escalations
  • Corrected Claims
Tel: 800-306-0732  
Claims status
  • Claim receipt, check run
Tel: 800-306-0732  
New providers, contracting, and EDI
  • Electronic billing set up or problems
Tel: 800-306-0732 ccaedisupport

Member Services

General questions
  • Initial contact 
Member appeals
  • Service denials - Process; how to respond
Member benefits
  • Member information; coverage 
Member eligibility
Tel: 866-610-2273

Fax: 617-426-1311
MassHealth Tel: 888-665-9993  

Member Enrollment

Outreach and Marketing
  • Referrals for potential members
Tel: 866-610-2273

Fax: 617-830-0534

Clinical Operations

Clinical Decision Support Team and prior authorization
  • Benefit and service authorizations
Tel: 866-610-2273

Fax: 855-341-0720

Dental Program Administrator: Scion

  • Claims to be processed
  • Member eligibility
  • Claims issues
  • Provider relations
Tel: 855-434-9243



General questions Tel: 866-610-2273

Fax: 857-246-8891


Provider Network

Provider Relations
  • Training, orientation, general questions
Tel: 866-610-2273

Fax: 617-517-7738
Provider Enrollment
  • New provider enrollment, provider date edits
Provider contracting
  • Requests to become a Commonwealth Care Alliance provider
  • Medical or Behavioral Health


Concerns and reporting
  • Fraud, waste, and abuse and compliance concerns
Tel: 800-826-6762
Compliance Hotline **anonymous**

**not anonymous**

Third Party Liability

COB, third party, Q & A Tel: 617-960-0441
ext. 1904

Interpreter Services

The provider or member may contact CCA’s Member Services department at (866) 610-2273 and they will connect them to the appropriate interpreter telephonically.
  • Please have the following information available: Members name and ID number.
 Our Member Services department is available during the hours of 8:00 a.m. to 8:00 p.m. (Monday thru Friday) 8:00am to 6:00pm (Saturday and Sunday).
Tel: 866-610-2273  
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Resources for Providers