Yesterday
• Posted by Provider Relations
You asked and we listened! Fidelis Care is pleased to announce that Authorization Determination letters on Fidelis Care’s Provider Portal, will now indicate if the letter is an Initial Adverse Determination (IAD) or a Final Adverse Determination Letter (FAD).
Current Letter Details: ABC Medical Center - Member Name - Auth#
New Letter Details: ABC Medical Center - Member Name - Auth# - IAD or FAD
To Access the Letters:
Use the menu on the left of the Provider Access Online home page to navigate to the File Downloads section.
On the File Download page, providers can search by File Type and File Created
Monday
• Posted by Fidelis Care
With all the increases in technology, it’s easy to forget that healthcare starts with the people who show up every day wanting to make a difference. At Fidelis Care, we are proud to work with caring and conscientious doctors across New York State.
Whether they are seeing patients in their office or administering care in a hospital or emergency room, doctors are the lifeblood of our healthcare system.
March 30 is National Doctors Day. On this annual observance, Fidelis Care shares our gratitude to the doctors and healthcare professionals who support the health and wellness of the members and local communities
Last Week
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2026.
The following codes have been added to the Medicaid Authorization Grid and requires prior authorization:
III. Outpatient surgery: The following services require prior authorization:
D. Skin surgery and other dermatological procedures:
· Only the following codes continue to require authorization for any place of service: A2030, A2031, A2032, A2033, A2034, A2035, A2036, A2037, A2038, A2039, A2040, A2041, A2042, A2043, A2044, A2045, G0681, G0682, G0683, G0684, 11200, 11201, 15271, 15274, 15275, 15276, 15734, 15769-15776, 15778-15829, 17340-17999, Q4101, Q4121, Q4186, Q4195, Q4196, Q4354, Q4355, Q4356, Q4357, Q4358, Q4359, Q4360,
Last Week
• Posted by Provider Relations
Pursuant to past guidance by the New York Department of Health (NYDOH), claims submitted under the medical benefit for medications must include a valid National Drug Code (NDC). Claims that do not include an NDC, or that include an NDC that does not match the billed HCPCS code, may be denied and/or not eligible for reimbursement.
Billing Guidance Reminders
Submit the HCPCS code that accurately reflects the drug administered.
Report the 11-digit NDC (5-4-2 format, no spaces or hyphens) that corresponds to the actual product administered.
Ensure the NDC matches the HCPCS code and that both align to the service documented