Today
• Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective July 1, 2026.
The following codes have been added to the Medicaid, CHP, Essential Plan, Ambetter Metal-Level Plans, and Medicare Authorization Grids and require prior authorization:
0636U Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgG
0637U Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgM
0638U Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgG
0639U Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgM
Visit: Authorization Grids
Wednesday
• Posted by Provider Relations
Effective August 1, 2026, Fidelis Care will implement a Site of Care Optimization Program to promote cost-effective, high-quality care for members receiving infusion therapies enrolled in Essential Plans.
Under this initiative, providers will be asked to transition eligible members from outpatient hospital infusion settings to clinically appropriate home infusion or ambulatory infusion suite (AIS) options.
Infusion Providers: Visit fideliscare.org/Find-A-Doctor#/search for a complete list of contracted providers.
Program Highlights:
Focuses on therapies for conditions such as immune globulin disorders, Crohn’s disease, rheumatoid arthritis, psoriasis, multiple sclerosis, and rare diseases.
Supports improved access for members in rural or underserved communities.
Aligns with clinical and payer
Tuesday
• Posted by Provider Relations
Fidelis Care will host four Provider Office Hours in July 2026. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.
Provider Office Hours – July 2026
Topic: Fidelis Care – Back to Basics
When: Thursday, July 9th – 1PM – 2PM EST
Click here to register*
Topic: Fidelis Care and WellCare Quality Programs
When: Wednesday, July 15th – 10:00AM – 11:00AM EST
Click
Last Week
• Posted by Provider Relations
As you may be aware, Section 12006 of the 21st Century Cures Act, along with CMS guidance, required states to implement Electronic Visit Verification (EVV) for Personal Care Services by January 1, 2021, and for Home Health Care Services by January 1, 2023. As of 2026, EVV requirements are fully implemented, requiring applicable services to be electronically verified and documented, including the member receiving care, caregiver, service location, date, and type of service provided.
Next Steps
To ensure EVV data is accurately captured for providers delivering in-scope EVV services, Fidelis Care will require all providers — including existing EDI and Enterprise (ENT)
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