Submitting claims electronically leads to quicker payment of claims and saves costs in mailing. It also makes it easier for providers to receive a claim receipt and claim status report.
Fidelis Care’s preferred clearinghouse for electronic claims submission is Availity. To enroll, please call Availity Client Services at 1-800-AVAILITY (1-800-282-4548).
Claims can also be submitted through clearinghouse Ability, or another clearinghouse. Fidelis Care offers free online claims submission through Ability’s claims portal. To learn more about Ability, call 1-888-499-5465 or visit mdol.com/fideliscare. You also have the option to contact another clearinghouse to initiate 837-claim submission to Fidelis Care.Please confirm with the clearinghouse that they will forward claims to Fidelis Care on your behalf.
Electronic Submission of Corrected Claims
To submit corrected claims electronically:
- The original claim number must be submitted
- The claim frequency type code must be a 7 (replacement of prior claim)
- 2300 Loop, CLM Claim Information Segment, CLM05-3 Claim Frequency Type Code Element must be set to a 7 and 2300 Loop
- REF Original Reference Number (ICN/DCN) Segment where REF01 Element equals F8, REF02 Element must contain Fidelis Care Original Claim Number
- Only one correction for a Fidelis Care Original Claim Number should be submitted per day