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Get the online tools and resources you need to take care of your patients who are Fallon Health members.
Provider Tools
ProAuth authorization tool Provider look-up Procedure code look-up Eligibility verification Claims metric report Secure file transfers PCP panel report Referral monitoring report
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Training
ProAuth FAQ/training (updated) MassHealth ACO FAQs Cultural competency training Product training (University login)
Provider communication
Read Connection newsletter Past issues of Connection
News and notifications
January 2020 Connection newsletter
Medical Rx program FAQs Fallon Health Medical Pharmacy Prior Authorization Program (.pptx) Webinar recording
ProAuth training webinars
To attend a webinar, email askfchp@fallonhealth.org with your NPI number and the date and time you would like to attend. You'll will receive a follow-up email with webinar details and training material.
Medication Administration Visits (MAV) codes ACO home health providers: Our claims system has been adjusted and is now accepting Medication Administration Visits (MAV) codes T1502 and T1503. Effective August 14, 2019, providers may start submitting claims for these service codes. These MAV codes require prior authorization. Previously denied claims due to “not a covered benefit” are being processed retroactive to March 1, 2018. Please contact your Provider Relations Representative if you have any questions.
Fallon will collaborate with HCAS plans to streamline directory data updates (7/16/2019) Watch for more information in upcoming issues of the Connection newsletter.
Provider Directory requirements from CMS and NCQA 9/10/2017 The Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA) have enacted requirements that health plans engage providers in reviewing and maintaining provider directory information.
More news and announcements
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Contact your Provider Relations Representative:1-866-275-3247 askfchp@fallonhealth.org