Wellcare By Fidelis Care – New Explanation Codes on Dual Access Remittances
2/10/2022
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Posted by Provider Relations
Fidelis Care would like to make you aware of three new explanation codes you may see on remittances for Wellcare By Fidelis Care Dual Access members:
Explanation Code
- 918 - Member Liability
- The member is responsible for these out-of-pocket cost share amounts.
- 919 - Non-Billable Cost Share
- Do Not Bill Member; for this scenario the member is not liable for the cost share as the amount paid to the provider meets the contractual reimbursement.
- 920 - Bill Cost Share to Medicaid
- For this scenario, the associated cost share needs to be billed to Medicaid.
Please familiarize yourself with these new explanation codes and update your accounts receivable as indicated.
We thank you for your continued partnership in servicing the Wellcare By Fidelis Care membership. If you have questions regarding your remittance advice, please contact our Provider Call Center at 1-888-FIDELIS (1-888-343-3547) or your local Provider Relations Specialist.