Connection supplemental articles and policies – May 2015

Supplemental articles

Payment policies

These policies apply to Fallon Health and Fallon Total Care unless otherwise noted.

New policies – effective July 1, 2015:

  • Adult Day Health Payment Policy
  • Adult Foster Care Payment Policy
  • Aging Service Access Points (ASAP) Payment Policy
  • Telemedicine Payment Policy

Revised policies – effective July 1, 2015:
The following policies have been updated; details about the changes are indicated on the policies.

  • Assistant Surgeon Payment Policy – moved to Fallon Health template.
  • Cardiology Services Payment Policy – moved to Fallon Health template.
  • Laboratory and Pathology Payment Policy – Updated the reimbursement, referral/prior authorization requirements, and billing and coding sections.
  • Non-Covered Services payment policy – Updated list of non-covered services and moved to new template.
  • Vaccine Payment Policy – Updated link in first paragraph and table at the end of the policy.

Let’s connect


Thanks to all who participated in our annual Provider Satisfaction Survey. 

Since 2012, our vendor—The Meyers Group—has been surveying our providers by phone, fax and through web access. This year we are excited to announce that our Provider Satisfaction and Provider Loyalty came in at 84.4% in the top two opinion boxes. This is up 6.2% from 2013 in these overall categories. 

With that, we thank all of you for your honesty, participation and feedback. Your responses help us to provide you with better service that, in turn, enables you to serve our members, your patients, and ultimately make our communities healthy.

Please continue to reach out to our Provider Relations team that is here to help you with all of your health plan needs.

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Are you making changes?

  • Are you moving?
  • Are you changing your name, billing company or email address?
  • Are you closing or opening your panel?

Please help us to best communicate with you, our providers, and make sure that patients have the most up-to-date information about your practice. We need to have current demographic information to ensure that our members, your patients, have up-to-the-minute information on your practice.

By using the Standardized Provider Information Change form you can share this information with all health plans you do business with, especially Fallon Health. 

Please note: This form is not to be used for credentialing or contractual changes and, in certain limited circumstances, we may need to follow up with providers for additional information.

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