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Fidelis Care would like to inform our providers of new fax numbers being used throughout the organization. Please begin using the fax numbers listed below immediately.
Please note: Fidelis Care is currently in the process of updating all determination letters and other written correspondence to reflect the new fax numbers. While both fax numbers will work for a short time, we encourage all providers to begin using the fax numbers below, regardless of the fax number listed on the letter/correspondence.
Department
Previous Fax Number
New Fax Number
Type of Faxes
Behavioral Health Substance Abuse Requests
646-829-1421
833-663-1608
All Substance Abuse Requests
Behavioral Health Authorization Requests
718-896-1784
833-561-0094
Behavioral Health Authorization Requests (Excluding Substance Abuse)
Behavioral Health Children's Authorization
347-690-7362
833-663-1604
All Children's Behavioral Health Authorizations and Plans of Care (POC)
Behavioral Health Court Orders
877-584-9642
All Court Orders for Behavioral Health
Behavioral Health HARP Authorization
347-868-6427
833-561-0089
All HARP Behavioral Health Authorizations
Credentialing
716-636-2522
833-710-1981
Initial Credentialing Application/Provider Data Form (Participating Contract/TIN Required) Re-credentialing Application/Information
Government Affairs & Compliance
718-362-1271
833-710-1655
Independent Dispute Resolution Entity (IDRE) Inquiries
Medical Appeals
718-393-6779
833-710-2226
Pre-Service Medical Appeals for all Non Long Term Care Members
Member Services
877-533-2402
877-533-2403
Health Care Proxy (Medicare) Letter Log (Medicare and Medicaid) Medicare Disenrollment Pharmacy Faxes Medicare Bills
718-897-1988
833-710-1775
Baby Care Incentives Children and Adult Medical Records Health Care Proxy (Medicare) Medicaid Letter Log (Legal) MLTC Letter Log W-9 FORMS & PROVIDERS Bills and Claims Coverage of Benefits and Terminations Health Care Proxy Medicaid PCP Changes Pharmacy Reimbursements Authorizations Requests Summary of Doctor’s Appointment Transportation Documents
716-564-6250
833-710-1777
Transportation Authorizations for Non-Emergency Transportation
718-896-6832
833-710-1776
Letter Log (Medicare and Medicaid) Medicare HIPAA Letter NYSARC Forms Personal Care Services Faxes (Physician’s Order for Personal Care/Consumer Directed Personal Assistance) Pharmacy Faxes W-9 Providers/ Home Health Agency Coordination of Benefits (COB) Medicaid HIPAA Forms
MLTC
347-514-6161
833-710-1973
MLTC Members -SNF documents (Authorization Requests, Permanent Placement Forms, PRIs, Notice of Agreement to PP)
716-200-4637
833-710-1659
DUAL Members - All DME & authorization requests.
Provider Relations – Albany Region
518-463-8820
833-522-2805
PR Related Communication
Provider Relations – Buffalo Region
716-200-1770
833-710-1653
Provider Relations –
NYC Region
718-896-1924
833-522-2804
Provider Relations – Rochester Region
585-785-4001
833-710-1652
Provider Relations – Syracuse Region
315-437-4875
833-710-1923
Retention
718-393-6484
833-710-1648
For members to submit documentation required by NYSoH, LDSS or HRA in reference to their Renewal or Enrollment Application. This can be extended for providers as well to send documentation relevant to a members Renewal or Enrollment application.
Utilization Management - Physical Health
716-803-8307
833-663-1611
Authorization Requests and Clinical Documentation for Inpatient Rehab Requests (For Non Long Term Care Members)
347-868-6411
833-663-1602
Authorization Requests and Clinical Documentation for Inpatient ER Requests (For all Non Long Term Care Members)
If you have any questions, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.