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LATEST NEWS


Fidelis Care Authorization Grids Effective April 1, 2025
2/27/2025 • Posted by Provider Relations
The following section of the Fidelis Care authorization grids have been updated effective April 1, 2025.
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Reminder: CMS Correct Coding Guidelines and Duplicate Revenue Codes
2/18/2025 • Posted by Provider Relations
Fidelis Care would like to remind providers of CMS correct coding guidelines to prevent billing errors and potential audits. Fidelis Care has found instances where claims for the same service were billed multiple times using the same revenue code. Per CMS guidelines, providers must ensure that each service charge has a distinct revenue code.
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Fidelis Care Provider Bulletin - Volume 11, Issue 1 – Winter 2025
2/10/2025 • Posted by Provider Relations
Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community.
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New Quality Care Incentives (QCI) Program for 2025 is Available
2/6/2025 • Posted by Provider Relations
Fidelis Care is pleased to announce that the new Quality Care Incentives (QCI) Program is now available on Provider Access Online.
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Most Recent 2024 QARR/HEDIS Gap Report Now Available
1/31/2025 • 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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Authorization Requirement Inquiries Will Transition to Self-Service on March 1, 2025
1/31/2025 • Posted by Provider Relations
Beginning March 1, 2025, all Fidelis Care providers inquiring about authorization requirements will need to use the Authorization Grids and the Authorization Requirement Lookup Tool available on fideliscare.org.
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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