Frequently asked questions
What is Berkshire Fallon Health Collaborative (BFHC)?
BFHC is a MassHealth Accountable Care Organization (ACO) Partnership Plan. It’s made up of Berkshire Health Systems (BHS), Community Health Programs, several Berkshire County community physician practitices and Fallon Health. Fallon Health is a leading health care services company that has been caring for MassHealth members for over 40 years. Their mission is to make their communities healthy. As a member, all of your health care is managed by your primary care provider (PCP). Your PCP will work with BFHC’s group of doctors, medical and community health centers to give you great health care.
What is an Accountable Care Organization (ACO)?
An ACO is a health plan that is accountable to provide quality care. An ACO helps you meet your health goals. ACOs have groups of PCPs and other providers. They work together to meet your overall health care needs. In an ACO, your PCP and their team is responsible for working with you and your other providers. They’ll help coordinate your care and connect you with available services and supports. This coordination can help you get the right care at the right time.
How can I be sure my PCP is part of BFHC?
Most Berkshire County PCPs are part of BFHC. All Community Health Programs providers are part of BFHC.
How do I join BFHC?
To join BFHC you must:
- Qualify for MassHealth
- Have a PCP that is part of the BFHC network
- Live in one of the cities or towns in our service area
If you meet the requirements above, call MassHealth to enroll. They can be reached at 1-800-841-2900 (TTY: 1-800-497-4648). They’re available 8 a.m. to 5 p.m., Monday through Friday. Or, visit MassHealthChoices.com
Will I pay more for BFHC?
No. There’s no cost to join BFHC.
What benefits do I get with BFHC?
As a BFHC member, you are covered for many important health care services, including doctor visits, hospital stays, rehabilitation and therapeutic services, and behavioral health and substance use disorder services. You’ll also get these healthy extras:
- A free car seat, and other “little extras” for expectant parents through the Oh Baby! program
- A free online health resource with info on conditions, medicines and other health topics
- Free help for people with asthma, heart disease, diabetes or chronic obstructive pulmonary disease (COPD)
BFHC can help you get counseling services. We can teach you about children’s services. And we can show you how to apply for food stamps and much more.
Which providers can I see?
You can see providers from the following locations:
- Barrington Family Medicine
- Berkshire Medical Center
- Berkshire Internists of BMC
- Berkshire OB/GYN of BMC
- Berskshire Osteopathic Health of BMC
- Fairview Hospital
- Fairview Internal Medicine
- Fairview Medical
- Hillcrest Campus of BMC
- Hillcrest Family Health Center
- Lenox Family Health Center
- MACONY Pediatrics
- North Adams Campus of BMC
- CHP Adams Internists
- CHP Barrington OB/GYN
- CHP Berkshire Pediatrics
- CHP Community Health Center
- CHP Family Dental Center
- CHP Great Barrington Health Center
- CHP Lee Family Practice
- CHP Neighborhood Dental Center
- CHP Neighborhood Health Center
- CHP North Adams Family Medicine
- Dalton Medical Associates
- East Mountain Medical Associates
- Family Practice Associates
- Suburban Internal Medicine
- Williamstown Medical of BMC
If your providers are not with BFHC you won’t be able to see them (except in cases where your BFHC provider deems it necessary for your care).
Will I be able to continue to see my specialists?
If you have a BFHC PCP, and your specialists are part of the BFHC network, you will be able to continue to see your specialists. To be sure that you can continue to see all of your doctors, you must make sure that they are in the BFHC network. You can do that by calling Fallon Health at 1-855-203-4660 (TRS 711) from 8 a.m. to 6 p.m., Monday through Friday. Or, you can look up doctors online using the "Find a doctor" link below.
If your specialist is not a part of the BFHC network, you will need to contact your PCP to determine if you can continue to see this specialist. You may need a referral or a Prior Authorization for some of your providers.
What is My Ombudsman?
My Ombudsman is an independent organization that helps individuals, including their families and caregivers, address concerns or questions that may impact their experience with a MassHealth health plan or their ability to access their health plan benefits and services. My Ombudsman works with the member, MassHealth, and each MassHealth health plan to help resolve concerns to ensure that members receive their benefits and exercise their rights within their health plan.
My Ombudsman is knowledgeable about member rights, contractual requirements of each health plan, benefits and services available to members, as well as resources in the community. My Ombudsman is able to connect with representatives at health plans and at MassHealth to investigate and resolve concerns quickly and appropriately.
Call: 1-855-781-9898
Email: info@myombudsman.org
Website: www.myombudsman.org
Office: 11 Dartmouth Street, Suite 301, Malden, MA 02148. Office is wheelchair accessible.
Walk-in hours: Mondays 1 p.m.–4 p.m. and Thursdays 9 p.m.–12 p.m. and by appointment.
Questions about BFHC?
Call us at 1-855-203-4660 (TRS 711) from 8 a.m. to 6 p.m., Monday – Friday.
Questions about MassHealth?
Call MassHealth at 1-800-841-2900 (TTY: 1-800-497-4648). They are open 8 a.m. to 5 p.m., Monday through Friday. Or, visit MassHealthChoices.com.
