New tools are available on MyFallon- click here to go to MyFallon

Authorization requirements and policies

The following links are to the approval requirements for certain services and benefits. In most cases, your provider will take care of authorization of services.  

Dental claim utilization and review criteria (pdf)
National standardized criteria to provide guidance for your clinical dental consultant

Diagnostic imaging services
Prior authorization requirements for high-tech outpatient diagnostic imaging, such as CT scans, PET scans, MRIs and Nuclear Cardiac Imaging

Medical policies
Policies for medical treatments

Pharmacy prior authorization documentation
Covered prescription drugs that have prior authorization requirements

Sleep therapy
Prior authorization requirements for sleep therapy, sleep studies and related supplies