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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.
As your health plan partner, Fidelis Care would like to inform you of the following updates to help ensure accuracy in claims submissions.
For COB Submissions Received without Claims Attached:
Effective on August 1, 2019, Coordination of Benefits (COB) adjustment requests or appeal submissions without a claim form attached (CMS 1500 or UB04) will be rejected and returned with a request for resubmission with a valid claim form. Providers must also use the Provider Reconsideration/Appeal Form, when appealing a claims adjudication decision, which is easily accessible on the Provider Portal. You may access the form here: Provider Appeals Form
These key steps are included in your current Fidelis Care Provider Manual, but have not been followed consistently. To ensure timeliness and accuracy, we will adhere to these standards going forward.
Assisting providers in staying abreast of the latest trends, policies, and studies.
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Verify member eligibility or renewal status, check claims, send e-scripts, and more.
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.
Apply to our network and become a part of the Fidelis Care mission.