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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.
To help protect sensitive information and meet New York requirements, we're adding multi-factor authentication (MFA) to the Wellcare and Fidelis Care provider portals. It's a quick, familiar verification step that makes signing in more secure while keeping the process simple.
Check out details about the upcoming login update.
As a reminder, the Centers for Medicare and Medicaid Services (CMS) guidelines indicate that claims billed for physical, occupational, and speech therapy services must be submitted with the appropriate modifier. Please ensure that your PT, OT, and ST therapy claims are submitted with the appropriate modifier to prevent payment disruption. The therapy modifiers are as follows: Therapy Modifiers: GN= speech therapy GO = occupational therapy GP = physical therapy Professional Claims (CMS-1500) billed with any of the “always therapy” codes, must be billed with the appropriate therapy modifier (GN, GO, GP) appended to the claim. Institutional Claims (UB-04) billed with revenue codes 42x, 43x, and 44x, must be billed with the appropriate therapy modifier (GN, GO, GP) appended to the claim as follows: • Revenue code 42x (physical therapy) lines may only contain modifier GP • Revenue code 43x (occupational therapy) lines may only contain modifier GO • Revenue code 44x (speech-language pathology) lines may only contain modifier GN.
For further information, visit: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10176.pdf
Please be advised that PT, OT, and ST therapy claims not billed with the appropriate modifier will be denied.
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To submit prior authorization request types, use the Fidelis Care provider portal.
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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