Welcome, Providers!

 

LATEST NEWS


Last Week • Posted by Provider Relations
Pharmacy Medication Guidance 90-day Supplies: Medicaid covers a 90-day supply for most prescription and over the counter (OTC) maintenance medications. Where practicable, practitioners and pharmacists may utilize 90-day supplies of long-term maintenance medications for individuals in quarantine or those that have been identified by the CDC as being at a higher risk for developing serious illness from COVID-19.   Medication Delivery: Pharmacies that choose to provide delivery to individuals quarantined may confirm receipt of the medications by the member through a phone call, text or email, in lieu of getting a signature.
3/9/2020 • Posted by Provider Relations
As a reminder, Fidelis Care will reduce payment for early elective deliveries without an acceptable medical indication. Claims for elective deliveries prior to 39 weeks, without medical indication, will be reduced as per New York State Medicaid policy.
3/3/2020 • Posted by Provider Relations
The New York State Department of Health (SDOH) invites Certified Home Health Agencies (CHHA), Licensed Home Care Services Agencies (LHCSA), and Fiscal Intermediaries (FI), operating in NYS, to register for in-person Home Care Cost Report Outreach Sessions.
2/25/2020 • Posted by Fidelis Care
The following sections of the Fidelis Care authorization grids have been updated effective April 1, 2020, and require prior authorization.
2/18/2020 • Posted by Provider Relations
The Member - Primary Care Provider (PCP) Change Request Form has been updated and is available on this site.
Newer Articles
Older Articles


eviCore Healthcare

Access the eviCore utilization management system.

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 status, and more.

Provider Bulletin

Read the latest Provider Bulletin and browse the archives.

Manuals and Forms

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