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8/30/2019 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2019. The following services require prior authorization based on the health insurance product as outlined below:
8/30/2019 • 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 07/15/2019.
8/27/2019 • Posted by Provider Relations
Effective October 1, 2019, Ovulation enhancing drugs and related medical services are covered when billed with the appropriate infertility diagnosis codes:
8/23/2019 • Posted by Provider Relations
Fidelis Care has partnered with the American Cancer Society (ACS), the New York State and City Departments of Health, and leaders of New York’s health care community to reduce the burden of cancer in New York.
8/5/2019 • 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.
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Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Electronic Transactions

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Important Information on Coverage Decisions

Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

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

Provider Access Online

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Submit Authorization Requests

Utilization management systems available to submit authorization requests.