Provider | Fidelis Care
Member
Providers
Shop For a Plan

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.

 

Latest Provider Bulletin

 


Provider Bulletin Archives ➔


2025-Provider-Bulletin-Fall_image


LATEST NEWS


Invitation to Fidelis Care’s February Provider Office Hours
1/29/2025 • Posted by Provider Relations

Office Hours

Fidelis Care will host four Provider Office Hours in February 2025. During the webinar, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.

Provider Office Hours – February 2025

 

Topic: Fidelis Care – Back to Basics
When:  Thursday, February 13th – 12PM – 1PM EST
Click here to register*

 

Topic: Fidelis Care and Wellcare Quality Programs
When:  Wednesday, February 19th – 10AM – 11AM EST
Click here to register*

 

Topic: Fidelis Care Behavioral Health Overview
When:  Wednesday, February 26th – 10AM – 11AM EST
Click here to register*

 

Topic: Utilization Management Overview
When:  Thursday, February 27th – 2PM – 3PM EST
Click here to register*

 

*Attendance will be limited to the first 300 registrants for each session.

 


The Back to Basics session will include:

  • Important Updates/Information
  • Product Portfolio
  • Credentialing and Demographic Changes
  • Authorization Requirements
  • Vendor Information
  • Claims and Billing Information
  • Provider Tools & Resources

 

The Quality Office Hours – Quality Initiatives session will include:

  • Importance of Directory Information 
    • Demographic Changes
  • How to Find Your Provider Partnership Associate (PPA)
  • New! Quality Provider Web Page
  • QARR/HEDIS Medical Record Chases
  • 2025 Quality Incentive Programs
    • Upcoming 2025 Quality Care Incentive (QCI) Program
    • 2025 Partnership for Quality (P4Q) Program
    • Most Vulnerable Patients (MVP) Reporting
  • Risk Adjustment & 2025 Continuity of Care (CoC+) Program
    • New! 2025 CoC+ Program
    • Monthly CDI Webinar sessions
  • 2025 RxEffect Program/Pharmacy
    • Updated pharmacy data for both Medicare/Marketplace LOBs
    • Extended day supply

 

The Behavioral Health session will include:

  • Introductions to the Provider Relations Team
  • Provider Tools & Resources
  • Demographic Changes
  • HARP Enrollment, H Codes, HCBS and CORE
  • Care Management
  • Children’s HCBS
  • Applied Behavioral Analysis (ABA)
  • Pros Redesign- Addition based on the new regulatory requirements.
  • Tip Sheets & Resubmission Requirements
  • External Resources

 

The Utilization Management sessions will include:

  • Prior Authorization Overview
  • Authorization Resources
  • Authorization Appeals Process
  • Provider Tools & Resources

 

Once you have registered, you will receive a confirmation email.  If you have any questions, please contact your Fidelis Care Provider Engagement Account Manager or Provider Partnership Associate. To find your designated representative, please visit Contact Provider Relations on our website.


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.

Join Our Network

Apply to our network and become a part of the Fidelis Care mission.