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Fidelis Care’s Pharmacy Services would like to provide a reminder and clarity on how to submit claims for medications billed under the member’s medical benefit, as well as the appropriate Servicing Provider to document when submitting a Pharmacy Prior Authorization request for such medications. A Pharmacy Prior Authorization Request form can be found on the Fidelis Care website within the Utilization Management Programs section.   Documenting the Appropriate Serving Provider When submitting a Pharmacy Prior Authorization, the Servicing Provider should be the individual provider, facility, or pharmacy who will be supplying and subsequently billing for the supply of the requested medication.  This should be

You asked and we listened!  Fidelis Care is pleased to announce that claim status letters are now available on Provider Access Online, Fidelis Care’s Provider Portal, in the File Download section.    The letters available on Fidelis Care’s Provider Portal now include: Closed Claim Letter Claim Appeal Letter   To access claim letters: Use the menu on the left of the Provider Access Online home page to navigate to the File Downloads section. On the File Download page can search by File Type and File Created date range. Click on the letter you would like to download.   To check the status of a claim: Use

The Department of Health has partnered with Public Partnerships LLC (PPL) as the single Statewide Fiscal Intermediary (SFI) for the Consumer Directed Personal Assistance Program (CDPAP). All Consumers and Personal Assistants in the CDPAP must change to PPL by March 28, 2025.   To avoid an interruption of services, members receiving CDPAP services must contact PPL as soon as possible. Providers are encouraged to share this enrollment information with all members receiving CDPAP Services.   How to Register with PPL: ·Option 1: Transition Over the Phone Call the customer support center at 1-833-247-5346, and they will assist the Consumers through the process. Also available: 1-833-278-4829 (Arabic),

Fidelis Care would like to remind our providers of plan changes effective January 1, 2025, for Ambetter From Fidelis Care and Essential Plans. In order for members to obtain the in-network cost share benefit for Diabetes and Maternity Services, providers should follow the below guidance when sending prescriptions to pharmacies for applicable members.   As a reminder, members who become pregnant are required to report their pregnancy to the New York State of Health Marketplace Phone Number below to be eligible for the Pregnancy Cost-Share Waiver. New York State of Health Marketplace Phone: (855) 355-5777 TTY: (800) 662-1220.  

Grants of $10,000 to $20,000 aim to improve behavioral health outcomes, especially in underserved communities Deadline to apply is 5 p.m. EDT March 28, 2025 LONG ISLAND CITY, NY (March 5, 2025) Fidelis Care, a statewide health plan with more than 2.4 million members in New York State and a Centene Corporation company, has opened the application process for its 2025 behavioral health grant program. The grants – ranging from $10,000 to $20,000 – are intended to enhance the integration of behavioral health and primary care through innovative strategies. These efforts aim to bridge care gaps for vulnerable populations by promoting comprehensive support. The application is