Information for providers
EMC employees use one network of doctors, but have difference cost-sharing between two distinct Fallon Health plan options: Select Care and The Advantage Plan.
The Advantage Plan: Tiering
Tier 1: This tier includes local doctors and hospitals like UMass Memorial, Saint Vincent Hospital, Tri-River Family Health Center, Tri-County Medical Associates, Southboro Medical Group, CentMass Association of Physicians (CMIPA) and Reliant Medical Group (formerly Fallon Clinic). Members will have lower out-of-pocket costs when they see a provider in Tier 1.
Tier 2: This tier includes all other providers and hospitals in The Advantage Plan network.
Look up your tier:
Search using our Provider Look-up tool
Our web-based tools reduce paperwork, save valuable time, and improve communication—and they’re available at no cost to you!
For access to:
- Eligibility verification
- Claims metric report
- Secure file transfers
- PCP panel report
- Referral monitoring report
please visit the Providers' section on www.fchp.org.