Welcome, Providers!



6/5/2019 • Posted by Provider Relations
Attention! Due to a scheduled system upgrade, Provider Access Online (provider portal) will be “read only” from Friday, June 7 at 6PM through Sunday, June 9, 2019.
5/23/2019 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective July 1, 2019. The following services apply to Medicaid, Child Health Plus, and HealthierLife (HARP) lines of business and require prior authorization: IV. Behavioral Health – Outpatient services:
5/15/2019 • Posted by Provider Relations
Providers, please remember to review content available in Provider Access Online (Fidelis Care’s secure Provider Portal) and the rest of this Provider section of the Fidelis Care website. Both locations are excellent resources of information about our programs and services.
5/14/2019 • Posted by Provider Relations
Fidelis Care can help you fight opioid misuse. More people are dying of opioid overdoses than ever before in New York State. According to the State Department of Health, more than 3,000 individuals died of an opioid overdose in 2016. Buprenorphine is the first at-home medication therapy proven to be clinically effective against opioid use disorder (OUD). Buprenorphine can be an essential tool for helping you treat your OUD patients.
5/7/2019 • Posted by Provider Relations
*Attention Specialty Medication Prescribers * This notice is to provide information regarding specialty medications. Members can obtain covered specialty drugs at any retail pharmacy in Fidelis Care’s network, as long as that retail network pharmacy accepts Fidelis Care’s specialty network terms and conditions. If your patient has difficulty obtaining this medication from his or her preferred network pharmacy, AcariaHealth...
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Authorization Resources

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

Electronic Transactions

Submit claims electronically with Fidelis Care.

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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.

Submit Authorization Requests

Utilization management systems available to submit authorization requests.