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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News and notifications

January 2019 Connection newsletter  (Updated 2/12/19)

  • MHQP Patient Experience Awards
  • Summit ElderCare® expands to Webster
  • NaviCare® Model of Care training
  • How does Summit ElderCare help with transitions of care?
  • Sequestration payment reductions
  • New Medicare opioid edits and programs for 2019
  • Medication confusion and your patients’ safety
  • Outpatient telemedicine expansion
  • Change in Adult Day Health Care
  • Updates to website
  • Validating your practice information
  • Medicare formulary changes effective 1/1/2019
  • 5-star rating from CMS
  • NaviCare clinical practice initiatives
  • CMS Preclusion List
  • Adult foster care accreditation requirements
  • Important information regarding claims with ZelisTM edits
  • And more

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.

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: