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In an effort to streamline provider demographic changes and provider termination requests, Fidelis Care has created two new electronic forms for providers to use.  Please use these forms to submit changes under a singular TIN. In order to expedite the request, all fields on the forms are required. If not complete, the request will be delayed. Forms available on fideliscare.org: Provider Demographic Change Request Form   Provider Termination Request Form   Once completed, the forms can be submitted electronically to SMProviderAttestationUpdates@fideliscare.org. In the subject line of the email, please enter Demographic Change/Termination Request for "Your Provider/Group Name" in "Your County" (i.e. Demographic Change Request

Fidelis Care would like to inform providers of Medicaid requirements when medical records are lost due to an unforeseen event.  Providers whose records have been damaged, lost, or destroyed are required to report that information as soon as practicable, but no later than thirty calendar days after discovery, to the New York State (NYS) Office of the Medicaid Inspector General (OMIG) Self-Disclosure Unit. Failure to report such incidents may result in a determination of overpayment, penalties, and/or sanctions. Please note: Loss/destruction/ corruption/inaccessibility of electronic records due to data corruption, theft, change in data vendor or other issues must also be included

Fidelis Care will host our Quality Provider Office Hours on September 24, 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions. Quality Provider Office Hours – September 2024   Topic: Fidelis Care and Wellcare Quality Programs When:  Tuesday, September 24th – 2PM – 3PM EST Click here to register*   *Attendance will be limited to the first 300 registrants for each session.   The Quality session will

Fidelis Care would like to remind providers of claim submission guidelines regarding Coordination of Benefits (COB) for Child Health Plus, Essential Plan, and Metal-Level products.   Child Health Plus: In accordance with the terms of the Subscriber Contract for Child Health Plus, no coordination of benefits will occur for claims submitted when another carrier is primary. This includes Medicare, any other governmental program, commercial or self-funded policies.   Essential Plan and Health Benefit Exchange: In accordance with the terms of the Subscriber Contracts for the Essential Plan and Health Benefit Exchange, no coordination of benefits will occur for claims submitted when Medicare or any other

Provider Access Online, Fidelis Care’s Provider Portal, is an easy-to-use, secure, self-service platform that provides your office with 24/7 access to the patient information you need - from authorizations and claims status, to eligibility, plan benefits, and more.   Our Portal saves valuable time for your administrative staff and provides the answers and resources you’re looking for - any time, on demand.   Use the Portal to: Follow claims and authorizations status in real time; and Access patient rosters, remittances, quality reports, and downloadable letters, including: Admission Approval Letter Appeal Approved and Out-Of-Network Denied Letter Appeal Decision Letter Appeal Denial Decision Letter Approval Letter