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LATEST NEWS


Children and Family Treatment and Support Services (CFTSS) Utilization Review Process Effective July 1, 2025
Friday • Posted by Provider Relations
Fidelis Care would like to notify our providers of an update to our Children and Family Treatment and Support Services (CFTSS) Utilization Review Process.
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Fidelis Care Authorization Grids Effective July 1, 2025
Thursday • Posted by Provider Relations
The following section of the Fidelis Care authorization grids have been updated effective July 1, 2025.
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Annual Medicare Special Needs Program (SNP) Model of Care (MOC) Provider Training
Last Week • Posted by Provider Relations
The Centers for Medicare and Medicaid Services (CMS) requires that providers receive Medicare Special Needs Program (SNP) Model of Care (MOC) Training annually.
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Invitation to Fidelis Care’s June Provider Office Hours
5/16/2025 • Posted by Provider Relations
Fidelis Care will host three Provider Office Hours in June 2025. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.
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Reminder: Mandatory Medicaid Compliance Program
5/16/2025 • Posted by Provider Relations
Fidelis Care has received notice from the Office of the Medicaid Inspector General (OMIG) of new compliance program requirements for Medicaid participating providers.
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Updated Evolent Authorization Requirements Effective June 1, 2025
5/16/2025 • Posted by Provider Relations
The following codes on the Evolent/Fidelis Care authorization grid have been updated effective June 1, 2025.
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Provider Access Online

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

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Social Care Network

Starting January 1, 2025, members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans will have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Join Our Network

Apply to our network and become a part of the Fidelis Care mission. 

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Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

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Authorization Resources

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

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Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

E-Transactions

Utilization Management (UM)

Find information and links to external vendor authorizations and to internal resources.

UM Resources