The Fidelis Care Blog

To help prevent claim denials and payment recoupments, Fidelis Care would like to remind providers of billing requirements for practitioner administered drugs (PADs) that are covered under the NYRx pharmacy benefit.

Providers, please remember to review content available in Provider Access Online (Fidelis Care's secure Provider Portal) and the rest of this Provider section of the Fidelis Care website.

We are committed to making it easier for providers to access the information and tools they need to support our members. Based on feedback and ongoing review, we are making several updates to the Provider section of fideliscare.org.

Fidelis Care is committed to ensuring accurate claims processing and compliance with state and federal requirements. Providers who identify an overpayment may self‑disclose and refund the amount owed by submitting a refund check along with the required documentation.

As part of our ongoing work to improve the prior authorization (PA) process for both providers and members, Fidelis Care wants to share some important updates to our PA requirements for Medicaid, Ambetter From Fidelis Care and Medicare lines of business.