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 UMass Memorial, Saint Vincent Hospital and Reliant Medical Group. Members will pay a lower copayment when they see a provider in Tier 1.
Tier 2: This tier includes all other providers and hospitals in the Advantage plan network.
Look up your tier:
The Direct plan
Download the Direct plan provider lists:
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.