Fallon Community Health Plan

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Call us 1-800-868-5200 (TTY users, please call TRS Relay 711.)
         Monday through Friday, 8 a.m. to 6 p.m. Eastern time 

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A doctor treats her patient
Providers

More you.
  • Provider Tools
  • Provider Manual
  • Medical management
    • Asthma tool kit
    • Forms
    • Health care guidelines
    • NaviCare clinical guidelines
    • Medical policies
    • MedSolutions radiology management program
    • Payment policies
    • Proton pump inhibitors - important news
    • Referral and preauthorization process
    • Sleeps studies and therapy
  • Pharmacy
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  • News and announcements
  • Resources
  • Frequently asked questions
  • Contact us

Related Links

  • Provider Manual
  • Contact us

Forms

When you’re in need of a standard FCHP form, this is the place. The forms most frequently needed by FCHP providers are listed below—simply click, download and print!

  • Attestation for OB/GYN Provider Status Form - FCHP MassHealth (pdf, 180 KB)
  • Caremark Pharmacy Fax Form (pdf, 6 MB)
  • Caremark Pharmacy Fax Form - Mail service (new prescriptions) (pdf, 272 KB)
  • Disease Management - Case Management Referral Form (pdf, 34 KB)
  • Health Insurance Claim Form (pdf, 272 KB)
  • Infertility Services Prior Authorization Request Form (Medical and Pharmacy) (pdf, 44 KB)
  • Material Request Form
  • MCE Behavioral Health Provider/Primary Care Provider Communication Form (pdf, 123 KB)
  • Pharmacy Prior Authorization Forms
  • Plan Determination Form (pdf, 912 KB)
  • Provider Update Form (pdf, 87 KB)
  • Request for Claim Review Form and Reference Guide (Replaces "Provider Claims Adjustment Request Form" and "Provider Appeals Request Form") 
  • Quit To Win referral forms
    • Clinton meeting location
    • Gardner meeting location
    • Leominster meeting location
    • Worcester meeting location
  • Request for Prior Authorization Form (pdf, 194 KB)
  • Skilled Nursing Facility Admission Form (pdf, 36 KB)
  • Skilled Nursing Facility Request for Continued Stay Form (pdf, 38 KB)
  • Special Formula Medical Necessity Form (pdf, 53 KB)
  • Third Party Liability Indicator Form (pdf, 33KB)
  • Universal Health Plan/Home Health Authorization Form (pdf, 112 KB) 
     

Is there an additional form or two you would like listed here? Let us know!

Quick links for providers

  • Eligibility verification
  • Claims metrics
  • Provider Manual
  • Provider Tools
  • Forms
  • Request information

More resources

Quick links

  • Members
  • Employers
  • Providers
  • Brokers
  • Fallon Senior Plan HMO - Medicare Advantage
  • Careers
  • News

Helpful tools

  • Find a doctor
  • Online drug formulary
  • Healthwise Knowledgebase
  • Provider Tools
  • Employer Tools
  • Quick Quote for Brokers
  • Well Now blog

Our plans and products

  • Insurance for businesses and municipalities
  • Fallon Senior Plan HMO - Medicare Advantage
  • NaviCare
  • Summit ElderCare (PACE)
  • MassHealth (Medicaid)

Employer group pages

  • City of Worcester Advantage
  • The Employee Advantage - UMass
  • Commonwealth of Massachusetts
  • Hanover
  • Federal Employee Health Benefits Program
  • Welcome, Worcester Academy employees

In memoriam
© 2012, Fallon Community Health Plan | All rights reserved. Web privacy policy
One Chestnut Place, 10 Chestnut Street, Worcester, MA 01608
1-800-868-5200 (TTY users, please call TRS Relay 711.), Monday through Friday, 8 a.m. to 6 p.m.,  Eastern time

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