Provider Manual
Doing Business with Fallon Health Weinberg
Provider relations, provider tools, how to work with Fallon Health Weinberg and more.
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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.
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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.
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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.
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Forms
Printable PDF versions of Fallon Health Weinberg's most frequently used forms.
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Medical Benefits and Health Record
Document standards, record keeping practices, and Medicare audit and record retention.
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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.
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