Welcome, Providers!

 

LATEST NEWS


6/18/2018 • Posted by Fidelis Care
We are pleased to announce that all necessary regulatory approvals have been received for Fidelis Care to become part of the Centene family of health plans effective July 1, 2018.
5/31/2018 • Posted by Provider Relations
Fidelis Care will make changes to our Medicaid Managed Care, Child Health Plus, and HealthierLife formulary effective, July 1, 2018.  Some of the changes relate to step therapy, prior authorization, quantity limitations, and drugs being removed from the formulary.  To review the list, download formulary changes.
5/18/2018 • Posted by Provider Relations
Fidelis Care is working to support the HEDIS Measure for Use of Imaging Studies for Low Back Pain (LBP). As defined by HEDIS, use of imaging studies for low back pain includes the percentage of members 18-50 years of age who had a primary diagnosis of low back pain and did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of diagnosis. 
7/13/2017 • Posted by Provider Relations
When submitting claims with a National Drug Code (NDC), please be sure to bill your claims with a valid unit of measure abbreviation. Listed below are the NDC valid units of measure abbreviations and their descriptions:
Newer Articles


eviCore Healthcare

Access the eviCore utilization management system.

Electronic Transactions

Submit claims electronically with Fidelis Care.

Join Our Provider Network

Be part of the Fidelis Care mission. 

Important Information on Coverage Decisions

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

Fidelis Care does not reward practitioners or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff that would encourage decisions that result in underutilization of services. 

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

Learn about Fidelis Care's Quality Management Program


Provider Access Online

Verify member eligibility, check claims status, and more.

Provider Bulletin

Read the latest Provider Bulletin and browse the archives.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications.