Submit Authorization Requests

Delegated vendor who manages prior authorization requests for: Physical Therapy Services, Occupational Therapy Services, and Speech Therapy Services.

Fidelis Care Medical Specialty Solutions – Radiology Cardiology Utilization Review Matrix 2023

Fidelis Care Medical Specialty Solutions – Radiology Cardiology Utilization Review Matrix 2022

Fidelis Care Medical Specialty Solutions – Radiation Oncology Utilization Review Matrix 2023

Fidelis Care Medical Specialty Solutions – Radiation Oncology Utilization Review Matrix 2022

Fidelis Care Medical Specialty Solutions – Provider Training Guide

Fidelis Care Physical Medicine Program - Provider Training Guide

Fidelis Care Physical Medicine FAQ

Submit Prior Authorizations via NIA

Provider Tip Sheets

Provider Tip Sheet: Physical Medicine

Provider Tip Sheet: Spine MRI and Spine CT

Provider Tip Sheet: Cardiac Solution Program

Provider Tip Sheet: Transthoracic Echocardiography (TTE)

Quick Reference Guides (QRG)

Quick Reference Guide: Physical Medicine

Quick Reference Guide: Cardiac Imaging Studies

Quick Reference Guide: Medical Specialty Solutions | For Ordering and Rendering Providers

Delegated vendor who manages prior authorization requests for: Orthopedic Surgical Procedures and Spinal Surgical Procedures. 

TurningPoint Clinical Policies

• Fidelis Care/ TurningPoint Healthcare Solutions CPT Codes - Cardiac
• Fidelis Care/ TurningPoint Healthcare Solutions CPT Codes - ENT
• Fidelis Care/ TurningPoint Healthcare Solutions CPT Codes - Musculoskeletal

2022

• Provider Tip Sheet: Musculoskeletal Surgical Procedures Requiring Prior Authorization (Effective Jan. 2022)

2021

• Fidelis Care/ TurningPoint | ENT FAQ (PDF)
• Fidelis Care/ TurningPoint | Cardiac FAQ (PDF)
• Fidelis Care/ TurningPoint ENT Provider Training Manual (PDF)
• Fidelis Care/ TurningPoint Cardiac Surgical Training Manual (PDF) 
• Fidelis Care/ TurningPoint Cardiac Surgical Quality and Safety Management Program Announcement Letter (PDF)
• Fidelis Care/ TurningPoint Ears, Nose, & Throat (ENT) Surgeries Management Program Announcement Letter (PDF)

2020

• Provider Tip Sheet: Musculoskeletal Surgical Procedures Requiring Prior Authorization (Effective Nov. 2020)
• Submit Prior Authorizations via TurningPoint Healthcare Solutions

2019

• Provider Tip Sheet: Musculoskeletal Surgical Procedures Requiring Prior Authorization (2019)

Electronic Prior Authorization Tip Sheet

Submit Prior Authorizations via:  Covermymeds or Surescripts

Oncology Services - Medicaid Managed Care and HealthierLife

• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 11/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 10/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 9/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 8/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 7/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 6/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 5/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 3/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 2/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 1/1/2023)
• Oncology Services - Medicaid Managed Care and HealthierLife (Effective 12/1/2022)

Oncology Services - Essential Plan and Metal-Level Products (QHP)

• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 11/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 10/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 9/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 8/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 7/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 6/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 3/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 2/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 1/1/2023)
• Oncology Services - Essential Plan and Metal-Level Products/QHP (Effective 12/1/2022)

Oncology Services - Medicare | Wellcare by Fidelis Care

• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 11/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 10/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 9/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 8/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 7/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 4/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 3/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 2/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 1/1/2023)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 12/1/2022)
• Oncology Services - Medicare | Wellcare by Fidelis Care (Effective 10/1/2022)