Welcome, Providers!

 

LATEST NEWS


10/30/2020 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective December 1, 2020.
10/20/2020 • Posted by Provider Relations
You have the best interest of your patients at heart. More than that, you have their trust. Your recommendation is the most effective way to ensure they get their flu shot.
10/14/2020 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective November 1, 2020.
10/13/2020 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids were updated effective October 1, 2020.
10/13/2020 • Posted by Provider Relations
Fidelis Care implemented three new post office (P.O.) boxes for certain provider claims correspondence in 2020. These P.O. boxes, along with additional processes, will help to improve our receipt and inventory tracking of certain provider correspondence mail for claims processing efficiencies.
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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.