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Now Available: 2022 Capitation Schedule
12/29/2021 • Posted by Provider Relations

As you know, Fidelis Care relies upon the receipt of membership information from the New York State Department of Health (SDOH) prior to issuing capitation payments. The date for receiving this information from the SDOH varies from month to month. In certain months, the availability of data may be delayed as much as one week. Nevertheless, Fidelis Care has historically made capitation payments as close to the first of each calendar month as possible. 

Presented below is Fidelis Care’s 2022 capitation check and Electronic Funds Transfer (EFT) schedule. Please refer to this to determine the timing of your monthly payment.  Over the years, we have strictly adhered to the schedule, however, these dates are subject to change pending membership data availability from SDOH.  Please note that 2022 EFT payments will be made in advance of the check mailing.

Capitation Month

EFT

Dates

Check Mailing

Dates

Capitation Month

EFT

Dates

Check Mailing

Dates

February

02/04/2022

02/10/2022

August

08/05/2022

08/10/2022

March

03/04/2022

03/10/2022

September

09/07/2022

09/09/2022

April

04/05/2022

04/08/2022

October

10/05/2022

10/07/2022

May

05/05/2022

05/10/2022

November

11/04/2022

11/10/2022

June

06/07/2022

06/10/2022

December

12/06/2022

12/09/2022

July

07/06/2022

07/08/2022

January

01/06/2022

01/10/2023

 

Fidelis Care supports the use of electronic transmissions for claims, remittance advices and payments in efforts to save paper and reduce costs. Fidelis Care encourages providers to contact their Provider Relations Representative to learn how to sign up for EFT.

Providers who electronically submit claims for non-capitated services will, in most cases, receive their reimbursement faster than those submitting via paper claims. Fidelis Care receives electronic claims through multiple electronic data clearinghouses that expedite and guarantee receipt of claims data and accelerate processing time. Fidelis Care strongly encourages all providers to submit electronically and will assist in developing appropriate protocols to accept electronic claims.

Please visit fideliscare.org to read the latest news about Fidelis Care as well as special announcements for providers. Fidelis Care's provider portal enables facilities and practitioners to view member eligibility and benefit plan summary, verify PCP selection, conduct provider searches and review claim status 24 hours a day, seven days a week. These tools facilitate timely communication and provide administrative cost savings to your facility or practice.

 

Fidelis Care is proud to be your health care partner.

 

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Social Care Network

Starting January 1, 2025, members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans will have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Required Cultural Competency Training

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Authorization Resources

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

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Utilization Management (UM)

Find information and links to external vendor authorizations and to internal resources.