Final Reminder: Patient Eligibility and Benefits Status Transitions to Self-Service on August 15, 2022
8/12/2022
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Posted by Provider Relations
Beginning August 15, 2022, all Fidelis Care providers inquiring about a patient’s eligibility and benefits will need to use either the Patient Search tool on Fidelis Care’s Provider Portal, Provider Access Online, or the Automated Eligibility system on our Interactive Voice Response (IVR) at 1-888-FIDELIS (1-888-343-3547).
Eligibility and benefits information will no longer be available by contacting the Call Center.
To help ease this transition, Fidelis Care recommends your office staff review our new video tutorial on using the Patient Search tool at fideliscare.org/PAO. Please remember your staff members need Patient Information Viewer access to perform a Patient Search on Provider Access Online.
To check a patient’s eligibility and benefits:
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. 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.
If you have any additional questions, please contact our Provider Call Center at 1-888-FIDELIS (1-888-343-3547) or your local Provider Relations Specialist.