Shop For a Plan

Submit Authorization Requests

This page explains the systems available to submit authorization requests



Helpful Resources | Utilization Management (UM)

Fidelis Care has engaged the following vendors to assist with utilization management for evaluation of medical necessity, appropriateness, and delivery of care to our members.  Below you will find information and links to external vendor authorization programs as well as links to internal Fidelis Care prior authorization submission resources.


Delegated Vendor Authorization Programs

Click to download provider tip sheets and follow links to Fidelis Care prior authorization submission resources. 

Evolent - National Imaging Associates, Inc. (NIA)

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

Submit Prior Authorizations via Evolent - NIA




    Fidelis Care Medical Specialty Solutions – Provider Training Guide

    Fidelis Care Physical Medicine Program - Provider Training Guide

    Fidelis Care Physical Medicine FAQ

    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

    Pharmacy – Electronic Prior Authorizations
    Use the links below for more information on how to submit electronic pharmacy prior authorizations via Covermymeds® and Surescripts®

    Electronic Prior Authorization Tip Sheet

    Submit Prior Authorizations via:  Covermymeds or Surescripts

    Evolent Oncology Program (formerly New Century Health)

    Oncology Services - Medicaid Managed Care and HealthierLife

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

    Oncology Services - Medicare | Wellcare by Fidelis Care

    Behavioral Health & Utilization Management

    For Prior Authorization of Behavioral Health services, please see the following contact information:

    Phone: (718) 896-6500 ext. 16072 


    Fax: (833) 561-0094

    For Provider Manuals, Forms and Policies (Including Behavioral Health Request Forms), please click here

    Authorization Resources

    To submit prior authorization request types, use the Fidelis Care provider portal.

    Forms and Applications

    For a complete list of Treatment/Service Request Forms, please visit Forms and Applications

    Pharmacy Services

    Formularies, utilization management programs, and specialty drug programs.