Welcome, Providers!



Yesterday • Posted by Provider Relations
Reminder: WellCare MLTC and LTSS members will transition to Fidelis Care MLTC and LTSS programs effective June 1, 2020. They are entitled to a 120-day Transition of Care Period.
Thursday • Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective July 1, 2020.
5/18/2020 • Posted by Provider Relations
As a reminder, effective June 1, 2020, WellCare of New York, Inc. Medicaid, Child Health Plus, Essential Plan, Health and Recovery Plan (HARP), and Managed Long Term Care members will transfer to Fidelis Care.  WellCare Medicare members are not affected by this change.   This announcement is to help providers with changes affecting current New York Medicaid members’ 2020 Claim Submissions, Member Eligibility, Claim Status Inquires, and Customer Service information.  We want to help your billing department process your claim submissions as efficiently as possible. Please use the date of service guidance on the Provider page of our website to send a claim submission to the correct payer to avoid an eligibility rejection.
5/12/2020 • Posted by Provider Relations
Coronavirus disease 2019 is a new and emerging illness in the United States. The virus causes a disease called COVID-19 that can lead to fever, cough and shortness of breath. There are thousands of confirmed cases in a growing number of countries internationally, and the virus is now spreading in the United States, including New York State. New information, obtained daily, further informs the risk assessment, treatment options, and next steps.
5/12/2020 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2020 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 3/16/2020.
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Important Information on Coverage Decisions

Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

Fidelis Care is committed to ensuring that members have the care and services they need. 

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