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Authorizations Issued by WellCare
5/7/2020 • Posted by Provider Relations

For members enrolled in a WellCare Medicaid, Child Health Plus, Managed Long Term Care, or an Essential Plan product, prior Authorizations issued by WellCare for dates of service on or after 6/1/2020, will transfer with the member’s eligibility, effective 6/1/2020, to Fidelis Care.  Fidelis Care will honor those authorizations.  Because those authorizations will automatically transfer to Fidelis Care, it is not necessary to request the authorization again when the member becomes eligible with Fidelis Care.

Beginning on 5/18/2020, providers can begin requesting prior authorization from Fidelis Care for dates of services on or after 6/1/2020 for these members.  Providers are encouraged to check the Fidelis Care Authorization Grids to ensure they are accessing the most current Fidelis Care authorization requirements for dates of service on or after 6/1/2020. 

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To submit prior authorization request types, use the Fidelis Care provider portal.

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Important Information on Coverage Decisions

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

Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

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

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