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LATEST NEWS


Thursday • Posted by Provider Relations
Fidelis Care encourages providers to participate and/or continue in behavioral health claims testing opportunities. Network providers who are participating in New York State’s Children and Family Treatment and Support Services and/or Children’s Home and Community Based Services program for children and youth enrolled in Medicaid Managed Care with health and behavioral health needs are encouraged to submit a request for claims testing.
Last Week • Posted by Provider Relations
An Authorized Generic is different from your "Typical Generic". Click here to find out more
6/5/2019 • 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 04/15/2019.
6/5/2019 • Posted by Provider Relations
Attention! Due to a scheduled system upgrade, Provider Access Online (provider portal) will be “read only” from Friday, June 7 at 6PM through Sunday, June 9, 2019.
5/23/2019 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective July 1, 2019. The following services apply to Medicaid, Child Health Plus, and HealthierLife (HARP) lines of business and require prior authorization: IV. Behavioral Health – Outpatient services:
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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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