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Claim submissions for physician-administered drugs require a valid 11-digit national drug code (NDC) number. Physician-administered drug claims submitted without a NDC number or with an invalid NDC number will be rejected.
This is a mandatory billing requirement that applies to all provider types and is in accordance with Section 6002 of the 2005 Federal Deficit Reduction Act (DRA). Claims must include the 11-digit NDC, in addition to the CPT/HCPCS code and number of units. The NDC dispensing quantity and the NDC unit of measurement are also mandatory. NDC information can be obtained from the drug invoice and/or package information. Additional billing information can be found by visiting eMedNY New York State Medicaid General Billing Guidelines Manual.
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.