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7/26/2018 • Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective September 1, 2018.
7/18/2018 • Posted by Provider Relations
Fidelis Care has posted a Viral Load Suppression tip sheet, which includes the HEDIS definition, diagnosis guidelines, effective management practice and protocol, billing and reporting practices, and pharmacy services information.
7/11/2018 • Posted by Provider Relations
Fidelis Care implemented a new opioid prior authorization requirement, which began on May 1, 2018.
6/29/2018 • Posted by Provider Relations
Fidelis Care is pleased to announce the Updated 2018 Quality Care Management Incentive (QCMI) Brochure is now available on Provider Access Online (provider portal).
6/29/2018 • 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 5/21/2018.
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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. 

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

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