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LATEST NEWS


Last Week • Posted by Provider Relations
Fidelis Care is pleased to announce the launch of a new and innovative Surgical Quality and Safety Management Program, effective October 1, 2019*. The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Fidelis Care members undergoing Musculoskeletal Surgical Procedures.
Last Week • Posted by Provider Relations
Fidelis Care has engaged National Imaging Associates, Inc., a Magellan Healthcare Company, to implement a new prior authorization program to manage outpatient (office and hospital) habilitative and rehabilitative physical medicine services, including services rendered in the home, effective on October 1, 2019*.
8/2/2019 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective September 1, 2019.
8/1/2019 • Posted by Provider Relations
Fidelis Care has updated the required Provider Appeals Form for providers to use for submitting Administrative Reviews and Provider Appeal requests.
7/31/2019 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2019 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 06/17/2019.
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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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