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LATEST NEWS


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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Members Empowered to Succeed (METS) - Behavioral Health Program
3/25/2024 • Posted by Provider Relations
The METS program is an integrated, whole health approach to support members with significant behavioral health challenges. It includes behavioral health, medical, therapeutic, pharmacy, and supplemental services.
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IMPORTANT: 2023MY QARR/HEDIS Medical Record Review - Second Requests are Now Available!
3/19/2024 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the medical record request letter and details for 2023 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible.
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Reminder: Fidelis Care MCG Cite Guideline Transparency Tool
3/13/2024 • Posted by Provider Relations
As of January 1, 2024, Fidelis Care has partnered with MCG Health to implement the MCG Cite Guideline Transparency Tool. Providers can access this feature through the Fidelis Care Provider Portal.
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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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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