Clinical Call Centers

For providers and pharmacists working with patients who are covered by the Massachusetts’ Medicaid program, MassHealth, it’s essential to have a resource for questions about prior authorization requirements or drug requests rejected at the pharmacy counter. At Commonwealth Medicine, the health care consulting division of UMass Medical School, we staff our clinical call center with registered pharmacists to provide the answers.

These pharmacists, who are part of our Clinical Pharmacy Services program, are available by phone six days a week. With an average wait time of 20 seconds, our calls are answered promptly and issues are addressed quickly — our staff’s average handling time is 3.5 minutes per call. We receive requests, render decisions, and process prior authorizations via phone, fax, electronic submission, and mail. All our prior authorization requests are reviewed within 24 hours of receipt, 365 days a year.

We monitor our call center staff for appropriate customer service interactions and quality of decisions. Metrics are monitored on a routine basis for friendly, fast, efficient call handling.