Welcome, Providers!

 

LATEST NEWS


Fidelis Medicare Advantage Members will have $0 cost share for Primary Care, Behavioral Health, and Telehealth Services for the rest of 2020
6/24/2020 • Posted by Provider Relations

Effective July 1, Fidelis Legacy Plan is expanding our $0 cost share for members of these plans:

  • Medicare Advantage Flex (HMO-POS Plan 022)
  • Medicare Advantage $0 Premium (HMO-Plan 024)
  • Medicare Advantage Without Rx (HMO-POS Plan 001) members

These members will have no cost share for the rest of 2020 when receiving these services from network providers:

  • primary care doctor visits for in-office, clinics, or in-home visits
  • outpatient behavioral health visits
  • telehealth or virtual visits with primary care, specialty, and behavioral health providers

Inpatient and urgent care are not included.

Beginning July 1, providers should not collect a cost share portion from members for these services. Our claims system will be configured to administer these adjusted benefits. We will continue to follow any accounting and reimbursement arrangements as outlined in each provider’s contract with us.   

We will continue to waive all prior authorizations, copays, and other costs related to COVID-19 testing, screening, and medically necessary treatment for these members. We ­also continue to waive prescription refill limits, and members are able to refill prescriptions prior to their refill date during this crisis.

Authorization Resources

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

Electronic Transactions

Submit claims electronically with Fidelis Care.

Join Our Provider Network

Be part of the Fidelis Care mission. 

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. 

Provider Access Online

Verify member eligibility, check claims, and more.

Provider Bulletin

Read the latest Provider Bulletin and browse the archives.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications.