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LATEST NEWS


9/12/2023 • Posted by Provider Relations
A DRG or Diagnosis Related Group is a mechanism used for payment by payers and certain facilities such as short-term acute care hospitals, long-term acute care hospitals, acute inpatient psychiatric hospitals, and acute inpatient rehabilitation facilities.
9/8/2023 • Posted by Provider Relations
Fidelis Care has made changes to our Child Health Plus (CHP) Formulary. Some of the changes relate to quantity limitations, authorization requirements, as well as drugs being removed and added to the formulary.
9/8/2023 • Posted by Provider Relations
Fidelis Care would like to notify our providers that service Fidelis Care New Jersey members (previously WellCare of New Jersey) with updated information on where to send authorization requests and other important contact information.
9/5/2023 • Posted by Provider Relations
As part of a year-end push to improve medication adherence, WellCare and WellCare By Fidelis Care are offering an additional financial incentive (Incentive Payment Program) to its providers who use RxEffect® to identify and take action in the following Star ratings medication therapy areas:
9/1/2023 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2023.
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Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Member Renewal Information

Health insurance will no longer be automatically renewed for Medicaid Managed Care, Essential Plan, Child Health Plus, or HealthierLife members.

Join Our Network

Apply to our network and become a part of the Fidelis Care mission. 

 

 

 

Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

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

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Utilization Management (UM)

Find information and links to external vendor authorizations and to internal resources.