Information for providers
The City of Worcester Advantage plans have two distinct networks: Advantage and Direct.
The Advantage plan: Tiering
Tier 1: This tier includes local providers affiliated with Saint Vincent Hospital and Reliant Medical Group.
Tier 2: This tier include local providers affiliated with UMass Memorial.
Tier 3: This tier includes all other providers and hospitals in the Advantage Plan and Advantage Qualified High Deductible Plan with HSA networks.
Look up your tier:
The Direct plan
Provider Tools
Our web-based tools reduce paperwork, save valuable time, and improve communication—and they’re available at no cost to you!
For access to:
- Eligibility verification
- Claims metric report
- Secure file transfers
- PCP panel report
- Referral monitoring report
please visit the Providers' section on www.fallonhealth.org.
* This tool is currently showing tiers for FY2020. Tiers will be updated for FY2021 on July 1.