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LATEST NEWS


1/8/2019 • Posted by Provider Relations
Some providers may not have received their QCMI performance reports.  We have identified the issue and are in the process of sending them out.  Fidelis will be mailing letters to affected providers with a copy of the performance report enclosed.
12/28/2018 • Posted by Provider Relations
Fidelis Care has made changes to our Medicaid Managed Care/Child Health Plus/HealthierLife; Metal Level; and Essential Plan Formularies. Some of the changes relate to quantity limitations, authorization requirements, as well as drugs being removed and added to the formulary.
12/28/2018 • Posted by Provider Relations
Fidelis Care is pleased to announce a new pilot program for our participating primary care and specialty providers who are delivering care to members of the Essential Plan (EP) and HealthierLife, Fidelis’ Health and Recovery Plan (HARP) for adults with behavioral health conditions most in need.
12/28/2018 • 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 11/12/2018.
12/20/2018 • Posted by Provider Relations
Fidelis Care is pleased to announce the new Quality Care Incentives (QCI) Brochure is now available on Provider Access Online.
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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. 

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