The Fidelis Care Blog

Effective August 1, 2026, Fidelis Care will implement a new pre-pay claims review process for certain claims that may involve Third-Party Liability (TPL) or Workers' Compensation coverage. This initiative is designed to help ensure claims are billed to the appropriate payer and processed accurately.

Effective August 17th, 2026, Pre- and Post-Decision Peer-to-Peer (P2P) discussions will no longer result in reconsideration of inpatient and post-acute care authorization determinations. Any reconsideration of an adverse coverage determination will instead be managed exclusively through the formal appeals process.

Fidelis Care would like to remind providers of the importance of using the appropriate submission process when requesting an expedited authorization review.

To better protect information and meet state requirements, we’re adding an extra layer of security when you log in to the secure Wellcare and Fidelis Care provider portals. We know logging in is part of your daily workflow, and this update is designed to add security while keeping the process simple and familiar.

Fidelis Care would like to inform providers that we are unable to accept calls from Artificial Intelligence (AI) entities or other automated systems to verify claim status, obtain remittance information, or respond to any other inquiries.