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LATEST NEWS


Updated Medication Prior Authorization Request Form
8/13/2024 • Posted by Provider Relations
Fidelis Care would like to inform providers of recent updates to the Fidelis Care Medication Request Form, that is used for requesting Medication Prior Authorizations under either the Medical or Pharmacy Benefit.
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Choosing Wisely - New Resource Available for Providers
8/7/2024 • Posted by Provider Relations
Fidelis Care would like to make providers aware of a new resource available. Choosing Wisely is an initiative of the ABIM Foundation that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments, and procedures.
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Annual Medicare Special Needs Program (SNP) Model of Care (MOC) Provider Training
8/5/2024 • Posted by Provider Relations
The Centers for Medicare and Medicaid Services (CMS) requires that providers receive Medicare Special Needs Program (SNP) Model of Care (MOC) Training annually.
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Invitation to Fidelis Care’s August Provider Office Hours
7/31/2024 • Posted by Provider Relations
Fidelis Care will host three Provider Office Hours in August 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions.
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Most Recent 2024 QARR/HEDIS Gap Report Now Available
7/31/2024 • 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 Provider Access Online (provider portal).
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Update - Peer-to-Peer/Reconsideration Review Process
7/31/2024 • Posted by Provider Relations
Effective June 24, 2024, Fidelis Care implemented changes to our Peer-to-Peer process. In response to inquiries from our providers, we are providing the following clarification and reminder.
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Provider Access Online

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

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Social Care Network

Starting January 1, 2025, members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans will have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Join Our Network

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

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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