Welcome, Brokers!

We want to inform you that we are currently experiencing high call volumes in our Provider Contact Center, which are impacting wait times. We understand the importance of timely support and appreciate your patience during this period.  Please consider using the Fidelis Care Provider Portal or Availity which offer convenient self-service options including but not limited to: claim status, authorization status and member eligibility. We will provide updates when available. Thank you for your understanding and continued partnership. If you have any questions, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here.  Fidelis Care is proud to be

Special Supplemental Benefits for the Chronically Ill (SSBCI) can be offered to Medicare Advantage (MA) members who have one or more complex chronic conditions, are at high risk for hospitalization or adverse health outcomes and require intensive care coordination. SSBCI aims to improve overall health outcomes for the chronically ill population by addressing social needs beyond traditional medical care such as food, housing, transportation, and gaps in care. The program is designed to support individuals by offering additional services beyond standard Medicare coverage. Members must qualify for SSBCI benefits Members must meet all three criteria to qualify: The member must require intensive

As you know, Fidelis Care relies upon the receipt of membership information from the New York State Department of Health (SDOH) prior to issuing capitation payments. The date for receiving this information from the SDOH varies from month to month. In certain months, the availability of data may be delayed as much as one week. Nevertheless, Fidelis Care has historically made capitation payments as close to the first of each calendar month as possible.    Presented below is Fidelis Care’s 2026 capitation check and Electronic Funds Transfer (EFT) schedule. Please refer to this to determine the timing of your monthly payment.  Over

Fidelis Care will host three Provider Office Hours in January 2026. During the webinar, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – January 2026 Topic: Fidelis Care – Back to Basics When:  Thursday, January 8th – 9AM – 10AM EST Click here to register*   Topic: Fidelis Care and Wellcare Quality Programs When:  Wednesday, January 21st – 10AM – 11AM EST Click here to register*

The following sections of the Fidelis Care authorization grids have been updated effective February 1, 2026.             The following codes have been added to the Medicaid DME Authorization Grid and require prior authorization: E0766  Electrical stimulation device used for cancer treatment, includes all accessories, any type E2606  Positioning wheelchair seat cushion, width 22 inches or wider   Visit:  Authorization Grids