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LATEST NEWS


Friday • Posted by Provider Relations
As you may know, WellCare Health Plans is now part of Centene, which operates as Fidelis Care in New York State.
Wednesday • Posted by Provider Relations
Fidelis Care is pleased to inform you that the medical record request letter and details for 2020 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO).
Last Week • Posted by Provider Relations
Fidelis Care has made submitting pharmacy prior authorizations easier and more convenient. We have partnered with CoverMyMeds and Surescripts to make it easy for you to request and access electronic prior authorizations (ePA) via the ePA vendor of your choice.
1/13/2020 • Posted by Provider Relations
Attention: 835/ERA Direct Recipients Only. As a reminder, in an effort to streamline Electronic Remittance Advice (835/ERA) delivery, Fidelis Care is asking our current direct recipients to request delivery through their preferred clearinghouse.
1/9/2020 • Posted by Provider Relations
Fidelis Care has created two new authorization treatment/service request forms (Audiology and Podiatry) for our members enrolled in our managed long term care product, Fidelis Care at Home. In addition, updates have been made to the existing Durable Medical Equipment (DME) form.
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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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