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Request Prior Authorization and Check Status Online via Provider Access Online!
9/10/2019 • Posted by Provider Relations

As a reminder, Prior Authorizations can be requested online via Provider Access Online (provider portal), which is available 24 hours a day, 7 days a week.  Use the “self-service” authorization form to submit your requests online when it is convenient for you ~ with no hold or wait time!

Did you know you could also check the status of authorizations using the provider portal? 
With this option, you no longer have to call in to check the status.

To get started:

                                             - Checking Authorization Status

  • For assistance:   Contact the Provider Call Center at 1-888-FIDELIS (1-888-343-3547) 

All Prior Authorizations can be submitted online, except the following:

Must be submitted via the appropriate fax line or by phone at 1-888-FIDELIS (1-888-343-3547):

  • Urgent Requests 

             o    Initial Inpatient Rehabilitation can now be submitted online via provider portal
             o    Inpatient Emergency Room Admission Requests Concurrent Requests

  • Pharmacy Medication Requests should be faxed using the prior authorization forms available here:
    Pharmacy Services

 Must be requested from eviCore via the eviCore Provider Portal, called in via 866-706-2108, or faxed
 in via 800-540-2406:

  • ​Outpatient high-technology Radiology services, Non-Obstetrical Ultrasounds, diagnostic Cardiology
    services, and Radiation therapy services 

*If you do not have a Provider Access Online user account established, and if you need assistance with setting up an account, please contact the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
 

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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. 

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