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LATEST NEWS


Today • Posted by Provider Relations
Fidelis Care is initiating a transition process for providers to identify members who are currently receiving group and family therapy services, and who will continue treatment beyond November 1, 2025, along with current frequency and duration.
Last Week • Posted by Provider Relations
Fidelis Care is partnering with Healthmap Solutions (Healthmap) to provide care coordination services within our kidney health management (KHM) program.
Last Week • Posted by Provider Relations
Effective November 1, 2025, Fidelis Care will begin outreaching for additional clinical information if a member remains hospitalized beyond seven (7) days. This outreach will initiate a concurrent review to assess medical necessity and support discharge planning activities.
9/29/2025 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective November 1, 2025.
9/29/2025 • Posted by Provider Relations
Effective October 1, 2025, Ambetter from Fidelis Care will implement a Site of Care Optimization Program to promote cost-effective, high-quality care for members receiving infusion therapies.
9/29/2025 • Posted by Provider Relations
Timely follow-up care after a mental health discharge is a vital component of recovery. Clinical guidelines recommend that individuals discharged from an emergency department (ED) or inpatient setting receive a follow-up visit within seven (7) days.
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Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Social Care Network

Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Apply to our network and become a part of the Fidelis Care mission. 

Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Utilization Management (UM)

Find information and links to external vendor authorizations and to internal resources.