Fallon Health

Summary

Fallon Health is a regional health plan, part of Fallon Community Health Plan, offering dental and medical coverage operating in Massachusetts and Connecticut. Claims route under payer ID FALLN, with 8 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Fallon Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID

FALLNAlso seen as 10082, 1576, 22254, 3801, FALLON, FT254 and 2 more

Also known as

FCHP, Fallon (Transplant claims), Fallon Community Health Plan

Uses CAQH

YesApplication route: CAQH application only

Service area

MA, CT

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Common questions

What is the payer ID for Fallon Health?

The payer ID for Fallon Health is FALLN. Alternate IDs seen across clearinghouses include 10082, 1576, 22254, 3801.

How long does Fallon Health provider enrollment take?

Fallon Health provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Fallon Health require CAQH?

Yes. Fallon Health uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does Fallon Health require ERA enrollment?

Yes. Fallon Health requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.

What states does Fallon Health cover?

Fallon Health operates in MA, CT. Coverage can differ by plan and product line, so confirm the specific plan before you file.