New to Provider Tools?
Provider Tools
Our web-based tools reduce paperwork, save valuable time, and improve communication—and they’re available at no cost.
ProAuth authorization tool
Enter referrals and authorizations and check status.
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Electronic Funds Transfer and 835 Claim Payment/Advice
Fallon Health offers Electronic Funds Transfer (EFT) and the 835 Health Care Claim Payment/Advice through PaySpan.
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Look-up tools
Login is not required for these applications.
- Provider look-up
Search for providers (including contracted individual and ancillary providers) by provider name, city, type, and other criteria.
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Procedure code look-up
A searchable library of all active CPT and HCPCS codes. The look-up provides preauthorization requirements.
Provider Tools available through Fallon Health's Provider Portal
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Eligibility verification
Verify that your patients are eligible for the date of service.
Verify copayments, deductibles, and products.
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Claims metric report
Review your rejected claims with detailed rejection reasons.
Review reports online or download to your computer.
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Secure file transfers
Protect personal health information through secure transactions.
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PCP panel report
View members on your PCP panel.
See additions and deletions to your panel.
Review reports online or download to your computer.
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Referral monitoring report
View claims and member information for referrals you've made.