Provider Quality

Provider-Quality

To ensure a continued focus on quality, Fidelis Care is dedicated to engaging with providers to ensure our members get the best care possible. Quality is a critical component of the work we do at Fidelis Care. The Provider Relations Department works diligently to support providers in quality improvement initiatives.

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Provider Quality News

New Features Coming Soon for Fidelis Care and Availity Essentials

4/9/2025 • Posted by Provider Relations in Provider News

Fidelis Care is pleased to announce that providers will soon have access to correct and resubmit a paid or denied claim, and view and reconcile remittances through their Availity Essentials account.

On April 21, Fidelis Care providers will have the following new functionality available on Availity Essentials.

Claim Corrections - Correct and resubmit a paid or denied claim from the Claim Status Response page. Ask your Availity Essentials Administrator to assign you the Claim Status role if this task is appropriate for your role.
Remittance Viewer - Locate remittances with ease using the extensive search and filter options. You can also review and reconcile detailed remittance data in an easy-to-read format and gain visibility into claims associated with a check/EFT by downloading a Check Summary. Ask your Availity Essentials Administrator to assign you the Claim Status role if this task is appropriate for your role.

If you are unable to access remittances, contact your organization’s Availity Essentials Administrator. An Administrator from your organization must validate a check/EFT payment your organization has received within the last 30 days. Once the validation is complete, all users in your organization with the Claim Status role will have access to view remittances.

For more information, please log in to Availity Essentials and register here for an upcoming webinar. Registered providers will receive an email about live trainings the week of April 14^th from Availity.

Monday, April 21^st, 2 p.m. CST
Tuesday, April 22^nd, 12 p.m. CST
Wednesday, April 23^rd, 11 a.m. CST
Thursday, April 24^th, 3 p.m. CST

Please Note: You must be logged into your Availity Essentials account to register and attend the webinars. To register for an Essentials account, visit Register and Get Started with Availity Essentials

For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.

Provider Office Hours

Fidelis Care hosts webinars called “Provider Office Hours” several times each month to share information and answer any of your questions.

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Provider Satisfaction Survey

Your provision of quality care and services to our members contributes greatly to Fidelis Care’s success. One of the ways Fidelis Care prioritizes quality is making sure you are satisfied with your experiences. Our annual Provider Satisfaction Survey identifies areas to focus on for further improvement in the coming year. The Provider Relations Department works diligently to identify an action plan to address areas of improvement, while continuing to develop actions and interventions to improve the provider experience.

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