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April 2020 Connection newsletter
Medical Rx program FAQs Fallon Health Medical Pharmacy Prior Authorization Program (.pptx) Webinar recording
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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.
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