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Beginning August 13, 2018, providers submitting electronic or paper claims for non-emergent transportation services will be required to submit the pick-up and drop-off location zip codes on the claim. Please follow the claim billing guidelines below. Claim Billing Guidelines: • Electronic claims – Providers should work with their claim submission vendor for claim requirements for the 837P claim submission. o If you are using an online claim submission website – Providers should follow the directions for that specific software application. • Paper claims – Providers must submit the pick-up location zip code in box 32A and drop-off location zip code in box 32B on the CMS-1500 claim form. Non-emergent transportation claims that are billed incorrectly will not be accepted as follows: • Electronic claims – Will be automatically rejected back to the provider/billing vendor. • Paper claims – Will be closed in our Claims Processing System and a letter will be sent to the provider with the rejection reason: o “The Pick-Up/Drop-Off Zip Codes in Box 32 were invalid or missing”. o If your claim is rejected, be sure to submit a new claim form with the required zip codes to Fidelis Care within the timeframe as outlined in your provider agreement. For additional information on transportation, download Transportation Provider Manual
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To submit prior authorization request types, use the Fidelis Care provider portal.
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.
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