Physicians and providers

At Fallon Community Health Plan, we know that as a physician or other health care provider, you want to spend your time taking care of your patients. So we've developed a variety of tools and products designed to meet both your needs and the needs of your patients.

• Register for Provider Tools
• Eligibility verification
• Preauthorization tool
• Claims metric report
• Secure file transfers
• PCP panel report

• Provider look-up
• Procedure code look-up

• EDI companion guides
• Register for electronic data submission

• Online drug formulary
• Pharmacy prior authorization

• HMOs
• FCHP Direct Care (pdf)
• FCHP Select Care (pdf)
  
  Point-of-service and PPO
• FCHP Flex Care Direct (pdf)
• FCHP Flex Care Select (pdf)
• Fallon Preferred Care (pdf)
  
  Additional products
• Summit ElderCare (pdf)
• Fallon Senior Plan™ (pdf)
• FCHP Independent Care (pdf)
• FCHP MassHealth (pdf)
• Major Medical (pdf)

• Introduction
• Compliance: Federal and
  state false claims acts
• Privacy and confidentiality
• FCHP products
• Managing patient care
• Provider relations
• Peer review policy
• Credentialing procedures
• Member relations
• Additional resources
• Billing procedures
• Medical payment policies
• Forms
• Medical policies

• Forms
• Request materials

• Medical policies
• Health care guidelines

• MedSolutions Radiology Management Program
• 2008 HEDIS^® measures
• HealthCare Administrative Solutions, Inc.
• Beacon Health Strategies
• Healthwise^® Knowledgebase
• National Provider Identifier

FAQs

• Connection newsletter
• Educational events

Contact us