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Fallon Health

Fallon Health

This page contains information you can use to exchange healthcare transactions with Fallon Health using Stedi.
Use any of the following payer IDs to send transactions to Fallon Health using Stedi APIs or SFTP. Read the docs
Primary Payer ID
Stedi Payer ID
Payer ID aliases
,,,,,,,
Parent group
Fallon Group
Coverage types
Dental, Medical
Operating states
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY
Covered
Not covered

Supported transactions

Use Stedi to exchange the following transactions with Fallon Health using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Fallon Health.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Fallon Health to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to Fallon Health in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Fallon Health and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Fallon Health and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Fallon Health to review full payment details.
Enrollment process type
Multi-step
Activation timeframe
Weeks
Not supported

Dental claims

(837D)
Submit dental claims to Fallon Health and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Fallon Health.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Fallon Health and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Fallon Health today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • FCHP
  • Fallon Community Health Plan
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