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Stay informed about Fidelis Care policies and updates, and keep up to date on upcoming provider office hours and trainings.
Do you need assistance? Please visit our Contact Provider Relations page to find your designated Provider Relations Specialist.
To help protect sensitive information and meet New York requirements, we're adding multi-factor authentication (MFA) to the Wellcare and Fidelis Care provider portals. It's a quick, familiar verification step that makes signing in more secure while keeping the process simple.
Check out details about the upcoming login update.
To help prevent claim denials and payment recoupments, Fidelis Care would like to remind providers of billing requirements for practitioner‑administered drugs (PADs) that are covered under the NYRx pharmacy benefit.
Certain PADs are included on the Medicaid Pharmacy List of Reimbursable Drugs and may be billed directly to NYRx by a pharmacy. When these drugs are obtained through the NYRx Program—or provided at no cost—providers may not submit a medical claim for reimbursement of the drug itself.
Providers may only seek reimbursement for the administration of a no‑cost drug. PADs obtained via NYRx and billed to Fidelis as a medical claim will be denied. In addition, any payments issued by Fidelis that do not comply with these requirements may be subject to recoupment.
We encourage providers to review their billing processes to ensure claims are submitted correctly and in accordance with NYRx and Fidelis Care guidelines. Accurate billing helps avoid delays, denials, and potential recoveries.
For questions or additional guidance, please refer to the NYRx Program Resources or contact your Provider Engagement Account Manager. To find your designated representative, visit www.fideliscare.org/Provider/Contact-Provider-Relations.
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To submit prior authorization request types, use the Fidelis Care provider portal.
Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.
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