Electronic Data Submission

Fallon Health Weinberg accepts direct submission of Institutional and Professional claims, submitted in the HIPAA-compliant format.

Direct submission of claims

Submitting your claims directly to Fallon Health Weinberg eliminates the need for a clearinghouse and is offered with no transaction fee. Fallon Health Weinberg  offers the following ways to transmit your files: SFTP and Secure File Transfer.

Enroll to submit your claims directly to Fallon Health Weinberg

  1. Download the Provider Tools Enrollment Form (pdf)
  2. Complete the form and mail the registration information to:

    Fallon Health Weinberg
    Attn: EDI Coordinator
    10 Chestnut St.
    Worcester, MA 01608

Have a question? Contact our EDI coordinators at 1-855-827-2003.

Electionic submission of claims through a clearinghouse

Electronic claim submission offers quicker turnaround time, lower working costs, more efficient payments and a confirmation that claims have been received by the clearinghouse. Fallon Health Weinberg's EDI process is secure and HIPAA compliant. Please refer to the Billing Procedures Section of the Provider Manual to review our Electronic Data Transmission policies and procedures.

These items cannot be filed electronically:

  • Status checks
  • Invoiced items (such as supply charges for serum)
  • Claims requiring attached documentation

Electronic claim submission companion guides 

Fallon Health Weinberg is contracted with the following clearinghouses.

Relay Health (formerly McKesson)
Call 1-800-735-2963, option 3, or visit their website at www.relayhealth.com.

Change Healthcare (formerly known as Emdeon and WebMD)
Call 1-800-845-6592 or visit their website: www.changehealthcare.com.

You must enroll with one of the above contracted clearinghouses prior to claims submission.

System downtimes 

Routine downtime is scheduled weekly from 7 a.m. to 10 a.m. on Sundays to support maintenance and enhancements for all EDI transactions. Non-routine downtime will be communicated via email at least one week in advance. Emergency unscheduled downtime will be communicated to trading partners via email within one hour following the determination that emergency downtime is needed

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

Quick links

Provider Tools ► 
Provider Manual ► 
Forms ► 

Provider Tools

Our online provider tools reduce paperwork, save time, and improve communication.

Claims Metrics
Eligibility Verification
PCP Panel Report
Provider Look-up
Referral Monitoring
Secure File Transfers