Welcome, Brokers!

In an effort to streamline provider demographic changes and provider termination requests, Fidelis Care has created two new electronic forms for providers to use.  Please use these forms to submit changes under a singular TIN. In order to expedite the request, all fields on the forms are required. If not complete, the request will be delayed. Forms available on fideliscare.org: Provider Demographic Change Request Form   Provider Termination Request Form   Once completed, the forms can be submitted electronically to SMProviderAttestationUpdates@fideliscare.org. In the subject line of the email, please enter Demographic Change/Termination Request for "Your Provider/Group Name" in "Your County" (i.e. Demographic Change Request

Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. The NYSDOH requires that certain Access and Availability Standards be met by PCPs, OB/GYNs, specialists, and behavioral health providers where applicable. Click here to view the full list of standards, including situations and timeframes.   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here. 

Fidelis Care received notice from New York State Office of Addiction Services and Support (OASAS), that providers are required to bill OTP bundle services under the APG methodology effective November 3, 2025. This applies to Medicaid Managed Care (MMC) plans, including Mainstream MMC plans, HIV Special Needs Plans (HIV SNPs), and Health and Recovery Plans (HARPs). Initiative Timeline: Beginning July 1, 2024, providers were given the option to bill OTP bundle services either under the existing OTP bundle rate codes or the APG methodology.  The May memorandum also indicated that OASAS would zero out the bundle rate codes (7969-7976) after a

You asked and we listened!  Fidelis Care is pleased to announce that Health Savings Unit (HSU) Recovery letters are now available on Provider Access Online, Fidelis Care’s Provider Portal, in the File Download section.  To access the HSU letters: Use the menu on the left of the Provider Access Online home page to navigate to the File Downloads section. On the File Download page, providers can search by File Type and File Created date range. Click on the letter you would like to download.  HSU letters will include only the provider’s name and provider identification number. To dispute an HSU retraction, providers

Fidelis Care’s Pharmacy Services would like to provide clarification on how medications are covered under member’s medical and pharmacy benefits.   Medications Covered Under Fidelis Care Medical Benefit Medications that are administered to a member during an outpatient visit are covered under the member’s medical benefit.  The authorization requests and claims for these medications should be processed through Fidelis Care using the guidelines and tips below, for all Lines of Business. Physician Administered Drugs – medications administered to a member during an outpatient visit: Providers obtain medication via “buy-and-bill” or shipment to their practice site from a vendor of their choosing.