Provider FAQ

Q: I am a provider for Fallon Health Weinberg, who can I call if I have questions?

A: You may contact the Provider Service Line at 1-855-827-2003, or you can email us at: AskFHW@fallonweinberg.org.

Q: How can I become a participating provider for Fallon Health Weinberg?

A: If you are a provider who would like to join the Fallon Health Weinberg network, you may fax or email a Letter of Interest to Fallon Health Weinberg at:

Fax: 1-508-368-9902
Email: askFHW@fallonweinberg.org

A Fallon Health Weinberg network representative will contact you regarding next steps.

Q. How will I know if a specific organization is a participating provider?

A. Participating providers within the Fallon Health Weinberg network can be found by using our Find a Provider tool.

Q. How can I determine if a member is active with Fallon Health Weinberg?

A. Questions regarding member eligibility can be directed to 1-855-561-7247. You can also check eligibility online by using the Eligibility Verification tool. To register for access to our Provider Tools, download a Provider Tool registration packet (pdf), complete the forms and return them to Fallon Health Weinberg.

You can also find out if a member is active by checking a member's Fallon Health Weinberg ID card. All members receive an ID card when they enroll. This card should be photocopied for your office records.

Q. Who can I contact about my credentialing status?

A. You can call 1-855-827-2003 for answers to your credentialing questions.

Q. How can I submit a facility or group name change?

A. To update any information (e.g., phone and fax numbers, site address, billing address), please complete a Provider Update form (pdf, coming soon) and email it to askFHW@fallonweinberg.org. If there is a change to the billing address, please also include an updated W-9.

Q. How can I resign from the Fallon Health Weinberg network?

A. To terminate as a participating provider, please complete a Provider Update form (pdf, coming soon) and email it to AskFHW@fallonweinberg.org.

Q. I work at a Mental Health Center. Do I need to be credentialed?

A. Mental Health Centers are credentialed as facilities. Individual providers at a Mental Health Center do not need to be credentialed if the facility is credentialed as a Fallon Health Weinberg provider.

Q. Can I submit claims electronically?

A: Yes, Fallon Health Weinberg accepts claims electronically through one of two methods:

• Electronically through a clearinghouse
  To send your claims via this method, your office will need to enroll with one of Fallon Health Weinberg's contracted clearinghouses. Once enrolled, all you need to do is send your claims data through to the chosen clearinghouse. The clearinghouse will then pass the file through standard data specifications and send it directly into our claims payment system. You must be sure to notify a clearinghouse of your decision to submit claims to Fallon Health Weinberg through their system before attempting to do so. You are required to provide your NPI number to the clearinghouse. For more information, please see the Electronic Data Submission page.
• Direct Submission
  You can also submit claims directly. For more information, please see the Electronic Data Submission page, or you can call 1-855-827-2003, or email our EDI coordinators at EDI.Coordinator@fallonweinberg.org.