1-800-868-5200 (TRS 711)Mon., Tue., Thu., Fri.: 8 a.m. to 6 p.m. Wed: 10 a.m. to 6 p.m.
for:
Medical policies Detailed documentation for all current medical policies for treating Fallon members
Payment policies Payment policies and documentation for a variety of treatments and procedures
Radiology management
Sleep studies and therapy prior authorization and utilization management program Fallon partners with CareCentrix to provide sleep diagnostic and therapy management services for selected Fallon Health product lines.
Asthma tool kit The resources in this kit are provided to assist you in caring for your patients with asthma.
Clinical guidelines When should teenagers have an eye exam? How often should routine cholesterol screenings be conducted? View our recommended health measures and screenings.
Clinical practice initiatives for NaviCare members Documentation and guidelines for treating NaviCare members
Guidelines and requirements for NaviCare members in long-term care facilities (pdf)
HEDIS® measures Measures for preventive health care and condition-specific care.
ePA (electronic prior authorization tool) Training Guide (pdf)
Pharmacy prior authorization procedures (pdf)
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