Resources for providers

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

Quick links

News and notifications

April 2019 Connection newsletter

  • Provider Satisfaction Survey 
  • Fallon partners with Vital Decisions 
  • New plan designs 
  • New Group Insurance Commission (GIC) tiers 
  • NaviCare Model of Care training 
  • Smoking cessation 
  • Changes regarding claims with ZelisTM edits 
  • Serious Reportable Event reporting reminder 
  • New Medicare opioid edits and programs 
  • Validating your practice information 
  • 5-Star rating from CMS 
  • High-risk medication use in older adults 
  • Osteoporosis management in older women 
  • Colorectal cancer screening 
  • Comprehensive diabetes care 
  • Home health billing changes 
  • Billing reminder 
  • Adult foster care accreditation requirements

Fallon will collaborate with HCAS plans to streamline directory data updates (9/6/2018)
Watch for more information in upcoming issues of the Connection newsletter, or read HCAS' latest newsletter.

MassHealth 834 technical guidance (pdf, 3/8/2018)

MassHealth continuity of care transition for ACO/MCO plans (3/1/2018)

MassHealth ACO FAQ 1/4/2018
Beginning March 1, 2018, MassHealth members will have more options for getting care, including MassHealth Accountable Care Organization (ACO) Partnership Plans.

Verify or update your practice information  9/20/2017
Your practice information appears in our provider directories. Keeping your information current helps ensure that patients can locate and contact your practice.

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: