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Fidelis Care has created two new authorization treatment/service request forms (Audiology and Podiatry) for our members enrolled in our managed long term care product, Fidelis Care at Home. In addition, updates have been made to the existing Durable Medical Equipment (DME) form.
These forms can be found on our website fideliscare.org by accessing Providers > Manuals and Forms > Forms and Applications > in a new section titled: Treatment/Service Request Forms – MLTC (Managed Long Term Care)
Durable Medical Equipment Request Form Hearing Aid Services and Products Request Form Podiatry Services Request Form
Completed authorization treatment/service request forms must be faxed to fax number: (716) 803-8727.
If you have any questions, please contact the Fidelis Care Provider Call Center at (888) 343-3547.
Verify member eligibility or renewal status, check claims, send e-scripts, and more.
Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.
Apply to our network and become a part of the Fidelis Care mission.
Access the Provider Attestation Statement and submit completion of training.
To submit prior authorization request types, use the Fidelis Care provider portal.
Submit claims electronically for faster processing and reimbursement.
Find information and links to external vendor authorizations and to internal resources.