Welcome, Brokers!

To better protect information and meet state requirements, we’re adding an extra layer of security when you log in to the secure Wellcare and Fidelis Care provider portals. We know logging in is part of your daily workflow, and this update is designed to add security while keeping the process simple and familiar.   What to expect Starting soon, you will be asked to use multi-factor authentication (MFA) when logging in to the provider portal. After entering your username and password, you’ll confirm your login with a one-time code sent via SMS to your phone. Once you’re signed in, everything in the

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) providers — to submit

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 designated representative, please

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

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