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Important Authorization Update Regarding Covid-19
6/23/2020 • Posted by Provider Relations

Fidelis Care anticipates that the DFS Insurance Circular Letter (regarding the suspension of certain utilization review and notification requirements) will expire on June 18, 2020. Authorization requirements will be reinstated for claims with dates of service on or after June 19, 2020.  Providers are required to contact Fidelis Care for prior authorization on services as described in the authorization grid, and can complete this request via the portal or by dialing 1-888-FIDELIS.

Should there be additional direction from the state or an extension of the Circular Letter, Fidelis Care would be updating accordingly.

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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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