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Welcome, Providers!

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.

 

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LATEST NEWS


Coronavirus and the Suspension of Certain Utilization Review Requirements (Updated)
1/31/2022 • Posted by Provider Relations

As recommended in New York State Department of Financial Services Insurance Circular Letter No. 1 dated January 6, 2022, Fidelis Care has suspended the following prior authorization requirements for Medicare products:

Hospital to Hospital transfer between participating facilities

  • The hospital is expected to use its best efforts to provide notice to Fidelis Care within 48 hours of the transfer.
  • Please include information necessary for Fidelis Care to assist in coordinating care and discharge planning.

Skilled Nursing Facilities (SNF)

  • Providers will have up to 7 days to notify Fidelis Care of the admission. 
  • Fidelis Care will approve the first 7 days of the stay, and will conduct concurrent review for all days beyond day 7

 

Fidelis Care will continue to monitor guidance from New York State.


Provider Bulletin Archives

Assisting providers in staying abreast of the latest trends, policies, and studies.

Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Authorization Resources

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

Social Care Network

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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