Welcome, Providers!

 

LATEST NEWS


3/25/2019 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the medical record second request letter and details for 2019 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible.
3/22/2019 • Posted by Provider Relations
The purpose of this ALERT is to inform Providers that the way in which certain Medicaid members renew their coverage is changing. Medicaid MAGI individuals (eligible recipients through the Modified Adjusted Gross Income rules) may now need to renew their coverage through the NYSOH Marketplace rather than through the local Department of Social Services/ Welfare Management System (WMS.) Due to the large number of MAGI enrollees, the transition to NY State of Health Marketplace has been occurring in phases. The next phase of the transition will affect enrollees with a coverage end date of April 30, 2019. This will include Medicaid HARP (Health and Recovery Program) individuals who reside in all NY State counties, except for the five boroughs of NYC (Bronx, Kings, Manhattan, Queens, and Staten Island.)
3/22/2019 • Posted by Provider Relations
This communication is to inform you that a change in the format of Fidelis Care's 835 (ERA) will take place on 3/28/2019. This update is informational only and will not affect receipt of your 835 files. ERAs delivered by Fidelis Care will no longer have the Bank Routing information in the BOP segment BPR09.
3/21/2019 • Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective May 1, 2019.
3/15/2019 • Posted by Provider Relations
It is vital to educate our members on the importance of monitoring and controlling high blood pressure to prevent the increased risk of stroke and heart disease.
Newer Articles
Older Articles


Authorization Resources

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

Electronic Transactions

Submit claims electronically with Fidelis Care.

Join Our Provider Network

Be part of the Fidelis Care mission. 

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

Verify member eligibility, check claims, and more.

Provider Bulletin

Read the latest Provider Bulletin and browse the archives.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications.