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Claims Status Will Transition to Self-Service Function on November 15, 2022
10/14/2022 • Posted by Provider Relations

Beginning November 15, 2022, all Fidelis Care providers inquiring about claims status will need to use either Fidelis Care’s Provider Portal, Provider Access Online, or the Automated Eligibility system on our Interactive Voice Response (IVR) at 1-888-FIDELIS (1-888-343-3547).

By using either of these tools, your staff can quickly and easily learn the status of your claims.

 

Claims Status information will no longer be available by contacting the Call Center. 

 

To help ease this transition, Fidelis Care recommends your office staff review our Provider Access Online resources, including new video tutorials, at fideliscare.org/PAO.

 

Account Administrators should also use this time to look over the level of access given to staff and adjust accordingly. To perform a Claims Search, staff members need to be granted Claims Information Viewer access. Visit fideliscare.org/PAO for more information on managing Provider Access Online user roles.

 

Provider Access Online Instructions

1) Once logged in to the secure portal, use the menu on the left to navigate to the “Claims” screen.

2) Select how you want to search for the claim from the drop-down menu. You can choose:

  • Subscriber ID
  • Claim ID
  • Medicaid ID/CIN
  • Medicare ID
  • Patient Account Number
  • Provider NPI

3) Type the requested information in the selected field, enter the date range for the claims that you want to check, and click on Search.

4) All claims for the date range that you selected will be listed, and the statuses of the claims are listed on the right.

5) Click on an individual Claim ID for more information, including the Claim Summary, Payment Details, and Claim Line Items.

6) Click on a Claim Line Item, and you will get full details on the item.

 

IVR Application Instructions

To access the IVR application, call 1-888-FIDELIS (1-888-343-3547) and follow the prompts for “Claims Status.” Upon entering the Claims Status menu option, you will be asked to enter the following information to obtain claims status:

  • Employee Identification Number (EIN) or Tax Identification Number
  • Fidelis Care Member Identification Number
  • Member’s Date of Birth (format must be --- XX/XX/XXXX)
  • Date of Service (format must be --- XX/XX/XXXX)

Learn More: IVR Application

 

If you have any Provider Access Online questions, or need help registering, check with your Account Administrator, contact your Fidelis Care Provider Relations Specialist, or connect with our Call Center at 1-888-FIDELIS (1-888-343-3547).

 

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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.