Provider | Fidelis Care

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LATEST NEWS


1/12/2024 • Posted by Provider Relations
In an effort to improve the quality of care for our members, Fidelis Care will be requesting Essential Plan members select a Primary Care Provider (PCP) starting in 2024.
1/11/2024 • Posted by Provider Relations
Fidelis Care is pleased to announce that, effective January 1, 2024, Express Scripts® began processing pharmacy claims for our plan members.
1/11/2024 • Posted by Provider Relations
Fidelis Care has received notice from New York State that the NYRx Helpline for members will be transitioning to an existing Medicaid Helpline.
1/9/2024 • Posted by Provider Relations
The Recipient Restriction Program (RRP) is a medical review and administrative mechanism whereby New York State (NYS) Medicaid members with a demonstrated pattern of abusing or misusing NYS Medicaid services may be restricted to a specific healthcare provider (i.e., hospital, clinic, physician) or pharmacy to coordinate services.
1/5/2024 • Posted by Provider Relations
Fidelis Care is pleased to make the following webinars available to our provider partners.
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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.