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Use Provider Access Online to Quickly Check on Patient Eligibility and Benefits
6/8/2022 • Posted by Provider Relations

It’s easy to quickly check a member’s eligibility and benefits by using the Patient Search tool in Provider Access Online, Fidelis Care’s secure Provider Portal. Make sure your account administrator grants Patient Information Viewer access to any staff member who will access this robust tool.

 

After signing in, click on Patient in the left navigational menu, and then select how you want to search for your patient. You can use any of the following search functions:

  • Subscriber ID
  • Medicaid ID/CIN
  • Medicare ID
  • Social Security Number
  • Name and Date of Birth

 

Once you enter the requested information and the As-Of-Date, you will quickly see the Patient Details overview if the patient is a Fidelis Care or Wellcare By Fidelis Care member. Click on the patient’s name for full details, including Eligibility, Benefits, Patient Demographics, Primary Care Physician, and Authorizations.

 

Check Eligibility

Confirm the patient’s eligibility by product in the Eligibility section, including his/her effective date of coverage.

 

Check Benefits

The Benefits section provides a detailed, searchable list of the different services available to the patient, displaying important information such as covered benefits, network status, copayment, coinsurance, benefit limit, and deductible.

 

In addition to the Eligibility and Benefits information, the Patient tool also includes information on:

  • Patient Demographics: Review the patient’s personal data, and access the Patient’s Claims and Related Persons
  • Primary Care Physician: Find the patient’s PCP and the PCP’s NPI and phone number
  • Authorizations Submitted Online: Search for authorizations submitted for the member

 

Reminder: Provider Access Online to No Longer Run on Internet Explorer 

Beginning June 15, Internet Explorer (IE) will no longer be supported on Provider Access Online. We recommend the use of Google Chrome, Mozilla Firefox, or Microsoft Edge as the default browser. If you are currently accessing the portal through IE, please begin using one of the recommended browsers to ensure a seamless transition.

 

If you have any Provider Access Online questions, or need help registering, check with your account administrator , contact your Fidelis Care Provider Relations Specialist, or connect with our Call Center at 1-888-FIDELIS (1-888-343-3547).

 

Look for more communications from Fidelis Care on ways you can use the Portal to support your practice’s needs. Fidelis Care is proud to be your partner in quality health care.

 

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Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

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

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Utilization Management (UM)

Find information and links to external vendor authorization programs as well as links to internal Fidelis Care prior authorization resources.

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