Commonwealth Care Alliance (CCA) provides treating practitioners with an opportunity to discuss the outcome of a utilization management request with a CCA physician.
The peer-to-peer request must be made within one (1) business day of the denial notification and before requesting an appeal of the decision. If CCA upholds the denial during the peer-to-peer consultation, the member may appeal the decision or may designate the practitioner to appeal on their behalf.
Practitioners can request a consultation by calling Provider Services at 866-420-9332 or by faxing the completed Peer-to-Peer request form to CCA at 855-341-0720.
Please click the appropriate link below to view the Peer-to-Peer form.
Massachusetts – Peer-to-Peer form
Rhode Island – Peer-to-Peer form
We look forward to consulting with you on our members’ care.