Welcome, Providers!

 

LATEST NEWS


3/12/2019 • Posted by Provider Relations
Like all other health plans, Fidelis Care is required by the State Department of Health (SDOH) to submit complete diagnostic data for members enrolled in New York State Medicaid Managed Care health plans. In order to meet this requirement, we request medical records to ensure all diagnostic data is reported completely and accurately.
3/8/2019 • Posted by Provider Relations
As a reminder, Prior Authorizations can be requested online via Provider Access Online (provider portal), which is available 24 hours a day, 7 days a week. Use the “self-service” authorization form to submit your requests online when it is convenient for you ~ with no hold or wait time!
3/8/2019 • Posted by Provider Relations
Fidelis Care has made changes to our Medicaid Managed Care/Child Health Plus/HealthierLife; Metal Level; and Essential Plan Formularies.
2/27/2019 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective April 1, 2019.
1/31/2019 • Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective March 1, 2019.
Newer 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.