Provider Tools

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

illustration of a tabletNew to Provider Tools?

Register online ►

ProAuth authorization tool

Enter referrals and authorizations and check status.
Log in ► OR 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.
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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.

Provider Tools available through Fallon Health's Provider Portal

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

Manage your Provider Tools user account and password

Reset your password or unlock your account.