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Welcome, Providers!

Stay informed about Fidelis Care policies and updates, and keep up to date on upcoming provider office hours and trainings.

Do you need assistance? Please visit our Contact Provider Relations page to find your designated Provider Relations Specialist.

 

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Update: Fidelis Care Essential Plan Primary Care Provider Designation
10/11/2024 • Posted by Provider Relations

To improve the quality of care for our members, Fidelis Care began requiring that Essential Plan members select a primary care provider (PCP) as of April 1, 2024.

Starting November 1, 2024 , newly enrolled members and members who renew their coverage will have 30 days to self-select a PCP. If a member does not designate a PCP within the 30 days following renewal or enrollment, Fidelis Care will assign the member a PCP, similar to the Medicaid assignment process. Members will receive a letter from Fidelis Care with the PCP they are assigned.

Please note: Any member that has renewed in the past six months and has not selected a PCP will also be assigned a PCP beginning November 1, 2024. PCPs may see an influx of members on their member rosters beginning in November.

Providers are encouraged to remind patients about the benefits of having a PCP, including to ensure healthcare needs are addressed during annual physicals and regular checkups, to manage medications, and to coordinate care with other providers.

As a reminder, providers can view their patient rosters on the Fidelis Care Provider Portal under File Downloads. Portal users will need the Account Administrator or Patient Roster Viewer role to view patient rosters. For more information on the Provider Portal and to access resources available, please visit Provider Access Online Resources.

If you have any questions, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.

Thank you for partnering with us to support the health and wellness of our members!



Provider Bulletin Archives

Assisting providers in staying abreast of the latest trends, policies, and studies.

Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Authorization Resources

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

Social Care Network

Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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