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Monday • Posted by Provider Relations
Fidelis Care’s Secure Portals will be experiencing an outage this weekend. The Secure Portals (Member, Provider, and IVR Lookups) will be unavailable during the time period. Effective Friday 8/5 from approximately 11pm until Sunday 8/7 at 12am (EST), the portals will be offline due to planned maintenance. We’re sorry for the inconvenience. Thank you for your patience as we improve our web sites to serve you better.
Last Week • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2022 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 6/21/2022.  Please refer to the most recent "Non-Compliance Report" instruction letter to understand the information being provided on each tab of the Excel Spreadsheet.  Please notify any staff involved with quality management and advise that these documents have been posted. If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
Last Week • Posted by Provider Relations
Beginning August 15, 2022, all Fidelis Care providers inquiring about a patient’s eligibility and benefits will need to use either the Patient Search tool on Fidelis Care’s Provider Portal, Provider Access Online, or the Automated Eligibility system on our Interactive Voice Response (IVR) at 1-888-FIDELIS (1-888-343-3547).   By using either of these tools, your staff can quickly and easily learn a patient’s eligibility and benefits, without any wait times.   Eligibility and benefits information will no longer be available by contacting the Call Center.   To help ease this transition, Fidelis Care recommends your office staff review our new video tutorial on using the Patient Search
Last Week • Posted by Provider Relations
As stated in the April 2022 Medicaid Update article titled Medicaid Enrollment Requirements and Compliance Deadlines for Managed Care Providers, all Fidelis Care Medicaid Managed Care (MMC) network furnishing, ordering, prescribing, referring and attending (OPRA) providers must be enrolled with New York State (NYS) Medicaid program by August 31, 2022.  Providers servicing MMC members should, without delay, begin the enrollment process and complete all required forms, including certifications.  Effective September 1, 2022, Fidelis Care will deny payment to unenrolled pharmacies, other unenrolled practitioners, and providers for services provided and/or prescribed. Criteria for NYS Medicaid Enrollment The enrollment requirement is applicable only to enrollable provider types including pharmacies
Last Week • Posted by Provider Relations
In addition to authorization approval and denial letters, pending authorization letters are now available on Provider Access Online, Fidelis Care’s Provider Portal.  The portal is an easy-to-use, secure, self-service platform that provides your office with 24/7 access to the patient information you need – from authorizations and claims status, to eligibility, plan benefits, and more.   The downloadable letters available on Fidelis Care’s Provider Portal include: Admission Approval Letter Appeal Approved and Out-of-Network Denied Letter Appeal Decision Letter Appeal Denial Letter Approval Letter Approved Out-of-Network and Appeal Denial Letter Authorization approved and Our-of-Network Denied Letter Authorization Request Extension Letter Denial Letter Exhausted
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