Resources for providers

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

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Newspaper

News and notifications

April 2020 Connection newsletter

  • MHQP Patient Experience Awards 
  • New prior authorization requirement change for certain behavioral health outpatient services 
  • Free colorectal cancer screening program 
  • NaviCare® Model of Care training and successes 
  • Cultural competency training 
  • Provider enrollments and Medicare certification 
  • 1/1/20 PCP referral change for Medicare beneficiaries

Medical Rx program
FAQs
Fallon Health Medical Pharmacy Prior Authorization Program (.pptx)
Webinar recording

ProAuth training webinars 

Medication Administration Visits (MAV) codes
ACO home health providers: Our claims system has been adjusted and is now accepting Medication Administration Visits (MAV) codes T1502 and T1503. Effective August 14, 2019, providers may start submitting claims for these service codes. These MAV codes require prior authorization. Previously denied claims due to “not a covered benefit” are being processed retroactive to March 1, 2018. Please contact your Provider Relations Representative if you have any questions.


Fallon will collaborate with HCAS plans to streamline directory data updates (7/16/2019)
Watch for more information in upcoming issues of the Connection newsletter.

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:

1-866-275-3247
askfchp@fallonhealth.org