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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Providers

More you.
  • Provider Tools
  • Provider Manual
    • Introduction
    • Compliance and false claims acts
    • Medicare audit
    • Privacy and confidentiality
    • FCHP products
    • Managing patient care
    • Doing business with FCHP
    • Peer review policy
    • Credentialing procedures
    • Member appeals and grievances
    • Additional resources
    • Billing procedures
  • Medical management
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  • Connection newsletter
  • News and announcements
  • Resources
  • Frequently asked questions
  • Contact us

Member appeals and grievances

Below is a list of topics included in the “Member appeals and grievances” section of the Provider Manual. To view this section, click the link below.

  • Open the “Member appeals and grievances” section of the Provider Manual

Topics

  • Customer Service
  • Member appeals and grievances department, appeals and grievances procedures
  • FCHP/MassHealth appeals policies and procedures
  • FCHP/MassHealth grievances policies and procedures
  • NaviCare® HMO SNP appeals and grievances rights
  • Member rights and responsibilities

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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