Provider portal and online tools

Our web-based tools reduce paperwork, save valuable time, and improve communication—and they’re available at no cost.

New! Provider portal

We’re excited to announce our new provider portal for our contracted providers. This portal includes:

• Patient search and eligibility verification
• Claims status
• PCP panel status/member roster
• Authorization status
• Provider appeals
• Secure messaging

Log in ►   Register ►

Please note: This registration link is for the individual(s) in your organization who are identified as super users. If you are not a super user, please find out who is in your practice, and they will register you. If you use this registration link and you’re not a super user, your registration could be denied.

Providers will still register for and log in to ProAuth separately.

ProAuth authorization tool

Enter referrals and authorizations
Log in ►   Register ►   Learn more ►

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.
Learn more ►

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.

Legacy Provider Tools

These tools will be disabled on December 15, 2025. If you are a contracted provider, you can register for the new provider portal prior to that.

• 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.
• 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.
• Secure file transfers
  Protect personal health information through secure transactions.