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LATEST NEWS


6/20/2024 • Posted by Provider Relations
Fidelis Care has partnered with Pomelo Care to provide free 24/7 online pregnancy and infant care to eligible Medicaid Managed Care, HealthierLife (HARP), Essential Plan, and Ambetter from Fidelis Care Qualified Health Plan members.
6/14/2024 • Posted by Provider Relations
Fidelis Care would like to make providers aware of a scheduled outage of the Fidelis Care Provider Portal. Beginning at 10PM EST Friday, June 14, through 4PM EST Saturday, June 15, the Provider Portal will be unavailable due to an upgrade of supporting systems.
6/6/2024 • Posted by Provider Relations
The New York State Department of Health (DOH) is required to verify provider qualifications, training, and staffing requirements (i.e., background checks) annually and report this information to the Centers for Medicare and Medicaid Services (CMS), under the terms of the 1915(c) Children’s Waiver.
5/31/2024 • 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).
5/29/2024 • Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective July 1, 2024.
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Smiles-that-Shine

Provider Access Online

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

Member Renewal Information

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

Join Our Network

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.