2025/6/25
• Posted by Provider Relations
The following section of the Fidelis Care authorization grids have been updated effective August 1, 2025.
The following code has been added on the Medicare, Medicaid, Essential Plan, and Metal-Level Products Authorization Grids and require prior authorization:
III. Outpatient surgery:
P. CAR-T Therapy: Q2058
Visit: Authorization Grids
2025/6/24
• Posted by Provider Relations
Fidelis Care will host three Provider Office Hours in July 2025. 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 – July 2025
Topic: Fidelis Care – Back to Basics
When: Thursday, July 10th – 9AM – 10AM EST
Click here to register*
Topic: Claims and COB Overview
When: Thursday, July 24th – 2PM – 3PM EST
Click here to
2025/6/20
• Posted by Provider Relations
Fidelis Care would like to remind our providers of plan changes for Ambetter From Fidelis Care and Essential Plans in response to a recent NY Senate Bill addressing copayments for PrEP and PEP medications. The in-network cost share for members will be waived for medications used for PrEP and PEP, provided that an appropriate ICD-10 diagnosis code is documented on the prescription sent to the Pharmacy.
Below are updated lists of medications indicated for PrEP and/or PEP.
PrEP Medications:
Descovy Tab 200-25 MG
Apretude INJ 600 MG/3 ML
Tuvada 200-300MG; Emtricitabine-tenofovir 200-300MG
PEP Medications:
Tivicay Tab 50 MG
Isentress Tab 400 MG
Darunavir
2025/6/11
• Posted by Provider Relations
Fidelis Care would like to remind providers that Urgent and Concurrent Authorization Requests cannot be submitted through the Provider Portal, as this will cause delays in processing.
To expedite the processing of Urgent, providers should submit requests through:
Availity Essentials, or
Fax Urgent requests directly to: (800) 860-8720, and label the request as “Urgent”
Urgent Concurrent Authorization Requests and Concurrent Authorization Requests should be submitted by:
Faxing requests directly to: (800) 860-8720, and labeling the request as “Concurrent”
To register for an Availity Essentials account, visit Register and Get Started with Availity Essentials.
For additional questions, or if we can be of assistance in any
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