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LATEST NEWS


Most Recent 2024 QARR/HEDIS Gap Report Now Available
4/3/2024 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2024 QARR/HEDIS Care Gap Report has been posted on this site.
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Fidelis Care Pharmacy Benefits
4/3/2024 • Posted by Provider Relations
Fidelis Care’s Pharmacy Services would like to provide further clarification on how medications are covered under member’s medical and pharmacy benefits.
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Celebrating National Doctors Day
3/29/2024 • Posted by Provider Relations
March 30 is National Doctors Day. On this annual observance, Fidelis Care extends sincere gratitude to the doctors and healthcare professionals across New York State who work tirelessly to support the health and wellness of the members and local communities we serve.
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Updated: Essential Plan Eligibility Expansion Effective April 1, 2024
3/29/2024 • Posted by Provider Relations
Beginning March 2, 2024, current enrollees in Qualified Health Plans (Ambetter from Fidelis Care) who are within 200-250% FPL were notified via letter from NY State of Health about the expansion of Essential Plan (EP) coverage in New York State.
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Fidelis Care Authorization Grids Effective May 1, 2024
3/29/2024 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2024.
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Provider Access Online

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

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Member Renewal Information

Health insurance will no longer be automatically renewed for Medicaid Managed Care, Essential Plan, Child Health Plus, or HealthierLife members.

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Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Attestation Form

Authorization Resources

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

Provider Portal

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

E-Transactions

Utilization Management (UM)

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

UM Resources