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Submit Pharmacy Prior Authorization Requests Electronically
1/14/2020 • Posted by Provider Relations

Fidelis Care has made submitting pharmacy prior authorizations easier and more convenient.

We have partnered with CoverMyMedsand Surescriptsto make it easy for you to request and access electronic prior authorizations (ePA) via the ePA vendor of your choice.

ePA is Fidelis Care’s preferred way to receive prior authorization requests.  Submitting prior authorizations via ePA can:

  • Reduce the need for faxes and phone calls;
  • Often decrease the time it takes to receive a decision, allowing patients to start therapy sooner; and
  • Be easily accessible through a web-based portal or may be integrated into your electronic health record (EHR) platform

Read more on how to get started by selecting your ePA vendor of choice.

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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. 

Learn about Fidelis Care's Quality Management Program


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