Working with us

With Fallon Health as your partner, you can rest assured that we'll do most of the work. We have the answers to everything you need to know about Fallon Health .

Download the Administrative Handbook (pdf, Updated July 2019)

Our managed care consultants help you with:

  • Enrollment
  • Daily administration
  • Rate information
  • Member service opportunities
  • Product information

Learn more about how we simplify plan administration for you. You can reach your managed care consultant by phone at 1-800-333-2535 or via email.

Plan administration: a partnership that works

At Fallon Health we're committed to making your health plan administration run smoothly. The following programs and capabilities have been implemented to help you with everything from enrollment to the daily administration of your plan.

Dedicated managed care consultant
Every client works with a managed care consultant who will assist you with everything from rate information and member services to information about Fallon products.

Welcome Calling Program
Few HMOs reach out to new members the way Fallon Health does. With our Welcome Calling Program, our specially trained staff welcomes and orients new members to the plan and answers any questions they may have. We put you and your employees at ease right from the beginning.

Direct customer service access
Fallon's dedicated customer service staff is trained to provide friendly and efficient information and assistance to existing and prospective members. Our toll-free number is 1-800-868-5200 (TRS 711) Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m.

Web access
Members may use this website to get information about our products or to execute simple transactions such as changing their primary care provider or requesting member discounts or coupons. These and many other capabilities can be found in our "Members" section.

Multispecialty account service team
Group services personnel from several Fallon departments work as a coordinated account team to reduce administrative hassles and foster customer satisfaction.

Administrative Handbook - your comprehensive guide to our plans
Fallon Health is pleased to provide you with a handbook to help you administer our products. You'll find it informative and easy to use. We've included standard plan information, so your group contract may differ in some areas.

Your Administrative Handbook contains:

  • Descriptions of Fallon Health products
  • Information about Fallon departments and their roles
  • Important telephone numbers
  • Step-by-step instructions on how to complete various forms and transactions
  • Eligibility guidelines
  • COBRA, mini-COBRA and HIPAA compliance information
  • Instructions for filing claims and reporting use of services
  • Information about how to obtain assistance

Download the Administrative Handbook (pdf)