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.
• 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

• Eligibility verification
  Verify that your patients are eligible for the date of service.
  Verify copayments, deductibles, and products.
• Claims metric report
  Review your rejected claims with detailed rejection reasons.
  Review reports online or download to your computer.
• Secure file transfers
  Protect personal health information through secure transactions.
• PCP panel report
  View members on your PCP panel.
  See additions and deletions to your panel.
  Review reports online or download to your computer.
• Referral monitoring report
  View claims and member information for referrals you've made.