Provider Manual

Doing Business with Fallon Health Weinberg

Provider relations, provider tools, how to work with Fallon Health Weinberg and more.
Open the "Doing Business with Fallon Health Weinberg" section

Fallon Health Weinberg Overview

About Fallon Health Weinberg
Fallon Health Weinberg overview ►

Managing Patient Care

Medical management, pharmacy, benefits and services, and more
Managing Patient Care ►

Billing Procedures

Claims guidelines and submissions, payments, coding, and more.
Billing Procedures

Cultural Competence Plan

Compliance, policies, and your responsibilities.
Open the "Cultural Competence Plan" section

Enrollee Information

Rights and responsibilities, appeals and grievances processes for members, provider education, member education and more.
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Credentialing Process

Credentialing process, practitioner rights, hearings and appeals, and more.
Open the "Credentialing Process" section

Clinical Coverage Criteria

Documents for guiding decisions regarding diagnosis, management, and treatment of diseases and decisions regarding the appropriateness, medical need and efficiency of health care services. 
View Clinical Coverage Criteria

Forms

Printable PDF versions of Fallon Health Weinberg's most frequently used forms.
View Forms

Medical Benefits and Health Record

Document standards, record keeping practices, and Medicare audit and record retention.
View Medical Benefits and Health Record ►

Payment policies

Up-to-date policies on payment for medical services. Each policy includes an overview, policy and criteria, an explanation of when services are covered, and any exclusions.
View Payment Policies

Join our network

Fallon Health Weinberg is looking to contract with high quality physicians and licensed healthcare practitioners who are willing to make a commitment to managed care.
Learn more

Contact us

1-855-827-2003
Monday through Friday,
8 a.m. to 5 p.m.
AskFHW@fallonweinberg.org