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Fidelis Care would like to remind providers of claim submission guidelines regarding Coordination of Benefits (COB) for Essential Plans and Metal-Level products.
 

Essential Plan and Health Benefit Exchange *: In accordance with the terms of the Subscriber Contracts for the Essential Plan and Health Benefit Exchange, no coordination of benefits will occur for claims submitted when Medicare or any other governmental program is primary (except Medicaid).

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 visit Contact Your Designated Provider Relations Specialist. Thank you for being a valued Fidelis Care partner in the provision of quality care.

*Effective April 1, 2018, claims processed by Fidelis Care with a primary carrier explanation of benefits (EOB) will be denied as “Services not covered when benefits are covered by Primary Carrier”.