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The following section of the Fidelis Care authorization grids has been updated effective June 1, 2026.             The following code has updated been on the Medicaid, CHP, Essential Plan, and Ambetter Metal-Level Plans Authorization Grids and requires prior authorization: Q5111  pegfilgrastim-cbqv (udenyca)   Visit:  Authorization Grids

Fidelis Care would like to inform providers that we are unable to accept calls from Artificial Intelligence (AI) entities or other automated systems to verify claim status, obtain remittance information, or respond to any other inquiries.  Fidelis Care representatives may only engage with a live person to verify PHI and ensure HIPAA compliance.   Providers are also encouraged to use the Fidelis Care Provider Portal to obtain needed information. For more information on the Provider Portal, please visit:  https://www.fideliscare.org/Provider/Provider-Access-Online-Resources   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To identify your

Fidelis Care is continuing efforts to ensure compliance with Electronic Visit Verification (EVV) requirements under the 21st Century Cures Act. As part of this work, Fidelis Care has partnered with HHAeXchange (HHAX), a home care management solutions vendor.  Providers may choose to use HHAX to submit claims; however, the system must be used for EVV. Claims associated with visits that do not have validated EVV may be denied or subject to recovery. What Providers Need to Know HHAX must be used for EVV validation, even if claims are submitted through another method. Visits without validated EVV may result in claim denials

At Fidelis Care, provider feedback is essential to how we improve our programs, processes, and overall experience working with our network. To support more frequent and meaningful collaboration, we’re excited to introduce the Provider Advisory Community—a new online forum designed specifically for providers. What Is the Provider Advisory Community? The Provider Advisory Community is a private, online space where participating providers can share insights and perspectives on topics such as: Administrative and clinical challenges Digital tools and resources Opportunities for improvement The overall experience working with Fidelis Care Participants will also get an early look at upcoming initiatives and updates, allowing Fidelis Care