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LATEST NEWS


Member - Primary Care Provider (PCP) Change Request Form Update
Yesterday • Posted by Provider Relations
The Member - Primary Care Provider (PCP) Change Request Form has been updated and is available on this site.
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OASAS Inpatient SUD Treatment and OMH Inpatient MH Treatment
Last Week • Posted by Provider Relations
Effective 01/01/2020, OASAS licensed inpatient substance use disorder (SUD) treatment and OMH licensed inpatient mental health (MH) treatment authorization requirements have been updated in our authorization grids for all product lines of business.
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Most Recent 2020 QARR Non-compliance Report Now Available
Last Week • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2020 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 12/09/2019.
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WellCare Now Part of Centene
1/24/2020 • Posted by Provider Relations
As you may know, WellCare Health Plans is now part of Centene, which operates as Fidelis Care in New York State.
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IMPORTANT: 2020 QARR/HEDIS Medical Record Review Requests are Now Available!
1/22/2020 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the medical record request letter and details for 2020 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO).
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eviCore Healthcare

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Important Information on Coverage Decisions

Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

Fidelis Care is committed to ensuring that members have the care and services they need. 

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