Resources for providers

Change Healthcare has experienced a network interruption related to a cyber security issue. Effective 4/29/2024, Fallon Health has re-established our connection with Change Healthcare system for our 837 Health Care Claim transactions.

See more information about Fallon Health’s electronic data submission options.

Recent bulletins and memorandum regarding urgent care coverage

If you have questions concerning the recently issued guidance, you can contact Provider Relations at

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

Quick links


News & announcements 

July 2024 Connection newsletter

  • Changes to prior authorization requirements
  • Fallon Health member language and/or alternate format preferences
  • Deadline for MassHealth ACO first-time claim and corrected claim submissions
  • Helpful clarifications to the provider appeal process
  • CAQH: Action needed
  • Behavioral health needs in an inpatient setting
  • New president and CEO to start at Fallon Health July 1
  • And more

Effective 1/1/22, OptumRx is our pharmacy benefits manager

Opioid management program and pain management alternatives

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


More news and announcements

Interested in contracting with us?

Have questions?

Contact your Provider Relations Representative: