Welcome, Providers!

 

LATEST NEWS


10/12/2018 • Posted by Provider Relations
Claim submissions for physician-administered drugs require a valid 11-digit national drug code (NDC) number. Physician-administered drug claims submitted without a NDC number or with an invalid NDC number will be rejected.
10/1/2018 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2018 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 8/20/2018.
10/1/2018 • Posted by Provider Relations
For the 18th consecutive year, Fidelis Care wants to know more about your experience with us. Your office may have received a survey in the mail requesting you to complete a survey, which may be completed by paper or online.
9/19/2018 • Posted by Provider Relations
Annually, Fidelis Care is required by the Centers for Medicare and Medicaid Services (CMS) to submit complete diagnostic data for Medicare members. To help us obtain the necessary medical records for submission, Fidelis Care is working in partnership with Optum and CiOX Health*. If you have received a packet requesting medical records, please be aware that records must be received no later than December 14, 2018.
9/14/2018 • Posted by Provider Relations
Fidelis Care provides voluntary Population Health Management (PHM) programs that meet the care needs of its entire member population, across the continuum of care. The PHM programs focus on the “whole person” and the member’s entire care journey.
Newer Articles
Older 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.