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    OpenPayerToolsPayer Contact DirectoryFallon Health

    Fallon Health Contact Directory

    26 contact channels across 4 types (Email, Fax, Mailing Address, Phone) for claims, prior authorization, provider services, and more.

    Last verified Aug 25, 2026 from the payer's published directories.

    Phone

    9 rows

    ContactPurposeLine of BusinessHoursNotesSource
    1-866-275-3247, option 6Claims Status, Eligibility BenefitsAllMonday through Friday, 8:00 AM to 5:00 PM EST (or 8:30 AM to 5:00 PM EST per 270/271 guide); excluding major holidays | Monday through Friday, 8:30 AM to 5:00 PM EST; excluding major holidaysEDI Support / EDI Coordinator for electronic transactions, including claim status (276/277), claims (837), and eligibility/benefits (270/271) | EDI Support for eligibility and benefits (270/271) transactions - EDI claim status inquiries (276/277) and related electronic claim status support | EDI eligibility/benefits inquiries (270/271) and related electronic eligibility supportView source
    855-827-2003Credentialing Enrollment, Medical ManagementAllN/AProvider services line in the Fallon Health Weinberg provider manual for doing business/provider data updates. | Medical management / management program phone listed in the Fallon Health Weinberg provider manual. - Provider data updates / provider relations questions | Management ProgramView source
    800-424-1740PharmacyAllN/AFallback Rx call/fax line on pharmacy prior authorization page; page labels it 'Call or fax' and does not specify a plan type. - Call or fax line listed on pharmacy prior authorization pageView source
    844-657-0494PharmacyMedicareN/APharmacy prior authorization phone for Medicare plans; includes Fallon Medicare Plus and NaviCare. The page also groups PACE lines under the same phone number. - Pharmacy prior authorization; Fallon Medicare Plus - NaviCareView source
    844-720-0033PharmacyMedicaidN/APharmacy prior authorization phone for Medicaid/MassHealth ACO plans. - Pharmacy prior authorization; Fallon 365 Care - Berkshire Fallon Health Collaborative - Fallon Health-Atrius Health Care CollaborativeView source
    844-720-0035PharmacyAllN/APharmacy prior authorization line for commercial plans; callers are instructed to use plan name from member ID card to select the correct line of business. The page states the PBM is Optum Prior Authorization Department for fax/mail handling. - Pharmacy prior authorization; Commercial plansView source
    844-722-1701PharmacyAllN/APharmacy prior authorization phone for Fallon Health Weinberg-PACE. - Fallon Health Weinberg-PACEView source
    866-412-5394PharmacyAllN/ACVS Health prior authorization phone mentioned in the Fallon Health Weinberg provider manual for certain requests. - Prior authorization; CVS Health PA lineView source
    866-275-3247Prior Authorization, Provider Services, GeneralAllN/AProvider phone number listed on the Standardized Prior Authorization Request Form. | General Fallon Health Provider Services line with option for claims per presentation | Provider Services contact listed on Fallon provider pages. - Provider phone number on standardized prior auth form | Provider Services; Prompt 2 for claims (per Baycare Health Partners Fallon presentation) | Provider ServicesView source

    Fax

    10 rows

    ContactPurposeLine of BusinessHoursNotesSource
    508-368-9890Appeals DisputesAllN/AProvider claim review and appeals; form and supporting information may be faxed to the provider appeals coordinatorView source
    508-368-9175Medical ManagementAllN/AUtilization Management fax for inpatient notifications or supporting clinical documentation. - Inpatient notifications or supporting clinical documentationView source
    716-810-1906Medical ManagementAllN/AManagement Program fax to Request for Prior Authorization form in the Fallon Health Weinberg provider manual. - Management ProgramView source
    844-403-1029PharmacyAllN/APharmacy prior authorization fax for commercial plans; PBM mailing/fax handling shown as Optum Prior Authorization Department on the page. - Pharmacy prior authorization; Commercial plansView source
    716-810-1909PharmacyAllN/AFax for physician-administered drugs requiring prior authorization in the Fallon Health Weinberg provider manual. - Physician-administered drugs requiring prior authorizationView source
    844-403-1028PharmacyMedicareN/APharmacy prior authorization fax for Medicare plans; includes Fallon Medicare Plus and NaviCare. The page also groups PACE lines under the same fax number. - Pharmacy prior authorization; Fallon Medicare Plus - NaviCareView source
    855-633-7673PharmacyAllN/ACVS Health prior authorization fax mentioned in the Fallon Health Weinberg provider manual for certain requests. - Prior authorization; CVS Health PA faxView source
    888-656-6671PharmacyAllN/AFallback Rx fax line on pharmacy prior authorization page; page labels it 'Call or fax' and does not specify a plan type. - Call or fax line listed on pharmacy prior authorization pageView source
    508-368-9700Prior AuthorizationCommercialN/APrior Authorization Department; submit supporting documentation. No delegated UM vendor named in the retrieved official Fallon prior-auth pages. - Commercial plansView source
    508-368-9133Prior AuthorizationAllN/AUrgent Care Review fax on the Standardized Prior Authorization Request Form. - Urgent care reviewView source

    Mailing Addresses

    4 rows

    ContactPurposeLine of BusinessHoursNotesSource
    Fallon Health, Attn: Request for Claim Review/Provider Appeals, PO Box 211308, Eagan, MN 55121-2908Appeals Disputes, Claims SubmissionAllN/AProvider appeals; Attn: Request for Claim Review/Provider Appeals | Paper claims should be submitted by mail | Claim adjustments; Claims Department: Adjustment TeamView source
    Fallon Health Claims - Smart Data Solutions, 960 Blue Gentian Road, Eagan, MN 55121Claims SubmissionAllN/AWhen shipping paper claims that are not deliverable to a P.O. Box (e.g., FedEx, UPS)View source
    Fallon Health Attn: Provider Data Updates 1 Mercantile St., Ste. 400 Worcester, MA 01608Credentialing EnrollmentAllN/AProvider Data Updates mailing address in the Fallon Health Weinberg provider manual. - Provider data updatesView source
    Optum Prior Authorization Department P.O. Box 2975 Mission, KS 66201PharmacyAllN/APharmacy prior authorization mail address shown with Optum Prior Authorization Department. - Pharmacy prior authorization; Commercial plansView source

    Email

    3 rows

    ContactPurposeLine of BusinessHoursNotesSource
    edi.coordinator@fallonhealth.orgClaims Status, Eligibility BenefitsAllMonday through Friday, 8:00 AM to 5:00 PM EST (or 8:30 AM to 5:00 PM EST per 270/271 guide); excluding major holidays | Monday through Friday, 8:30 AM to 5:00 PM EST; excluding major holidaysEDI Support / EDI Coordinator for electronic transactions, including claim status (276/277), claims (837), and eligibility/benefits (270/271) | EDI Support for eligibility and benefits (270/271) transactions - EDI claim status inquiries (276/277) and related electronic claim status support | EDI eligibility/benefits inquiries (270/271) and related electronic eligibility supportView source
    AskFHW@fallonweinberg.orgCredentialing EnrollmentAllN/AProvider data updates email in the Fallon Health Weinberg provider manual. - Provider data updatesView source
    askfchp@fallonhealth.orgGeneralAllN/AProvider Services email listed on Fallon provider pages. - Provider ServicesView source

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    Every contact in this directory comes from documents the payers publish themselves, such as provider manuals, quick reference guides, and contact pages, and each payer page shows when its contacts were last verified. You can see all of our data sources and how we process them.

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