Resources for providers

Get the online tools and resources you need to take care of your patients who are Fallon Health members.

Quick links

Newspaper

News and notifications

January 2020 Connection newsletter

  • New infusion therapy program
  • New program for medical benefit drug management
  • Fallon Medicare Plus crosswalk
  • PCP referral change for Medicare beneficiaries
  • CMS Star ratings
  • Medicare Health Outcomes Survey
  • New technology to help fight fraud
  • New Caregiving section

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

ProAuth training webinars 

  • Thursday, December 19, 2019, 2:00 - 3:00 p.m.
  • Monday, December 23, 2019, 10:00 - 11:00 a.m.
  • Monday, December 30, 2019, 8:30 - 9:30 a.m.

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

Have questions?

Contact your Provider Relations Representative:

1-866-275-3247
askfchp@fallonhealth.org