Welcome, Providers!

 

LATEST NEWS


7/11/2018 • Posted by Provider Relations
Fidelis Care implemented a new opioid prior authorization requirement, which began on May 1, 2018.
6/29/2018 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2018 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 5/21/2018.
6/28/2018 • Posted by Provider Relations
As of June 29, 2018, Fidelis Care's formulary for Medicaid Managed Care, Child Health Plus, and HealthierLife lines of business will no longer require a Prior Authorization for Aripiprazole (generic Abilify) Tablets for patients 6 years of age or older, within a quantity limit of #30 tablets/30 days.
6/27/2018 • Posted by Provider Relations
Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community. Articles included are:
6/21/2018 • Posted by Provider Relations
Fidelis Care will make changes to our Medicaid Managed Care, Child Health Plus, and HealthierLife formulary effective August 1, 2018.
Newer 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 numerous health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward practitioners or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff that would encourage decisions that result in underutilization of services. 

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

Learn about Fidelis Care's Quality Management Program


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.