Welcome, Providers!

 

LATEST NEWS


Fidelis Care Partnering with Optum and CiOX Health for Medicaid Medical Record Retrieval
3/12/2019 • Posted by Provider Relations

Like all other health plans, Fidelis Care is required by the State Department of Health (SDOH) to submit complete diagnostic data for members enrolled in New York State Medicaid Managed Care health plans. In order to meet this requirement, we request medical records to ensure all diagnostic data is reported completely and accurately.  Fidelis Care has partnered with Optum and CiOX Health to gather and review these records.  In the next two weeks, CiOX representatives will be reaching out to you to coordinate record retrieval. 

If you receive a packet requesting medical records, please provide the records as soon as possible. There are several options available to providers for record submission.  Please review the packet you receive to identify the submission option most convenient for you and your practice. If you receive a packet and have any questions, please contact CiOX Health at chartreview@cioxhealth.com, or at 877-445-9293, 8AM – 9PM EST, Monday through Friday.
 

eviCore Healthcare

Access the eviCore utilization management system.

Electronic Transactions

Submit claims electronically with Fidelis Care.

Join Our Provider Network

Be part of the Fidelis Care mission. 

Important Information on Coverage Decisions

Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on numerous health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward practitioners or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff that would encourage decisions that result in underutilization of services. 

Fidelis Care is committed to ensuring that members have the care and services they need. 

Learn about Fidelis Care's Quality Management Program


Provider Access Online

Verify member eligibility, check claims status, and more.

Provider Bulletin

Read the latest Provider Bulletin and browse the archives.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications.