Provider Quality

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 2025 capitation check and Electronic Funds Transfer (EFT) schedule. Please refer to this to determine the timing of your monthly payment.  Over the years, we have strictly adhered to the schedule, however, these dates are subject to change pending membership data availability from SDOH.  Please note that 2025 EFT payments will be made in advance of the check mailing.

Fidelis Care supports the use of electronic transmissions for claims, remittance advices and payments in efforts to save paper and reduce costs. Fidelis Care encourages providers to contact their Provider Engagement Account Manager to learn how to sign up for EFT.

Providers who electronically submit claims for non-capitated services will, in most cases, receive their reimbursement faster than those submitting via paper claims. Fidelis Care receives electronic claims through multiple electronic data clearinghouses that expedite and guarantee receipt of claims data and accelerate processing time. Fidelis Care strongly encourages all providers to submit electronically and will assist in developing appropriate protocols to accept electronic claims.

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 your health care partner.