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Fidelis Care will host four Provider Office Hours in November 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 – November 2026   Topic: Fidelis Care – Back to Basics When:  Thursday, November 5th – 9AM – 10AM EST Click here to register*   Topic: Timely Access to Care – Access and Availability Standards When:  Tuesday, November 10th – 2 PM – 3

The following sections of the Fidelis Care authorization grids have been updated.           The following section of the Medicaid, CHP, Essential Plan, Ambetter Metal-Level Plans, and Medicare Authorization Grids and requires prior authorization effective October 1, 2026: III.      Outpatient surgery: The following services require prior authorization:                    D.  Skin surgery and other dermatological procedures:          Only the following codes require authorization for any place of service: A2046, A2047, A2048, A2049, A2050, Q4207, Q4223, Q4243                              V.       Outpatient and DME Services: The following services require prior authorization:                    A.    Diagnostic testing:                          Proprietary Laboratory Analysis: 0666U, 0668U, 0669U, 0689U, 0692U, 0694U, 0698U         The following codes have been updated on the

To facilitate the timely processing of provider demographic and termination requests, and to ensure appropriate member notification, Fidelis Care would like to remind providers of the required submission timeframes and methods. Providers are encouraged to review these requirements carefully and submit all requests in accordance with the outlined procedures.   Timely Submission Requirements Provider Demographic/Office Changes: Submit at least 30 days prior to the effective date. Provider Terminations: Submit at least 60 days prior to the effective date. Please note: The effective date of the requested change will be no earlier than the date Fidelis Care is notified.   Submission Methods Online: Directory changes can

To ensure that claims for EVV-applicable services are supported by a valid Electronic Visit Verification (EVV) record prior to payment, this guidance outlines billing requirements, verification processes, denial criteria, and provider responsibilities. These requirements support program integrity, regulatory compliance, and accurate reimbursement for authorized services. This billing guidance applies to all providers rendering services subject to Electronic Visit Verification requirements, including but not limited to: Personal Care Services (PCS) Consumer Directed Personal Assistance Services (CDPAS) Other services designated by federal or state EVV requirements Fidelis Care requires that all EVV-applicable services be supported by a valid EVV transaction documenting service delivery. Claims for