fidelis patient portal prior authorization

Do I need prior authorization?

For Prior Authorization of Behavioral Health services, please see the following contact information: Phone: (718) 896-6500 ext. 16072 Email: qhcmbh@fideliscare.org. Fax: (718) 896-1784. For Provider Manuals, Forms and Policies (Including Behavioral Health Request Forms), please click here.

Does Medicaid require pre authorization?

Jul 31, 2018 · Fidelis Care is pleased to announce that we have 3 new inpatient prior authorization fax forms available on this site. Be sure to fill out the forms completely with all relevant information to help us expedite the processing of your requests. The new forms below can be found on this site located under Provider Resources, click Manuals and Forms, click the …

Does GHPP require prior authorization?

The Fidelis Prior Prescription (Rx) Authorization Form allows a prescribing physician to request coverage for a prescription drug. This document is not required if the drug is already on the insurance provider’s formulary; however, should all other formulary medications prove insufficient in treating the patient’s illness, coverage for non-preferred/non-formulary drugs can be obtained.

Does Fidelis cover birth control pills?

Apr 15, 2022 · If your authorization was created more than 90 days ago, you will need to search for it. Click the ‘ Search All Authorizations’ link to begin your search. Enter the member’s Subscriber ID number in the Subscriber ID field and click the Search button. After clicking the Search button, the Authorizations for that member will be displayed.

Does Fidelis requirements authorization?

Fidelis Care does require authorization of post stabilization services and inpatient admissions, after emergency room services are completed. All facility admissions are reviewed for medical necessity.Jul 1, 2020

How do I check my Fidelis Care status?

Call Member Services at 1-888-FIDELIS (1-888-343-3547).

What is prior authorization in healthcare?

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

What is fidelis timely filing limit?

General information for claims submission: IMPORTANT – Claims must be submitted within 90 (ninety) days from the date of service.Jul 19, 2018

How do I find my Fidelis member ID?

Member ID You can find your ID number on your insurance card. Please enter your Member ID. Email Address (Member Portal Account users only) We will contact you through your Member Portal email address. If you do not have a Member Portal account, please register before submitting your question.

How do I find my Fidelis ID number?

Simply call us at 1-888-FIDELIS (1-888-343-3547) and follow the prompts to get started. Don't forget: Once you order your ID card over the phone, visit the Fidelis Care Member Portal online at members.fideliscare.org to print out a temporary ID card.

Who is responsible for obtaining prior authorizations?

Who is responsible for obtaining prior authorization? The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider.

What is prior authorization process?

Prior authorization—sometimes called precertification or prior approval—is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

How can I speed up my insurance authorization?

16 Tips That Speed Up The Prior Authorization ProcessCreate a master list of procedures that require authorizations.Document denial reasons.Sign up for payor newsletters.Stay informed of changing industry standards.Designate prior authorization responsibilities to the same staff member(s).More items...

How do I file a claim with Fidelis?

Fidelis Care offers free online claims submission through Ability's claims portal. To learn more about Ability, call 1-888-499-5465 or visit www.mdon-line.com/fideliscare. You also have the option to contact another clearinghouse to initiate 837-claim submission to Fidelis Care.

Is Fidelis Care New York Medicaid?

Fidelis Care, a leading health insurer that serves all of New York State, offers free or low-cost comprehensive health coverage, including Medicaid Managed Care, Medicare Advantage, Child Health Plus, and plans available through NY State of Health, The Official Health Plan Marketplace.

Where do I send my Fidelis claim?

Clinical appeals must be received within sixty (60) business days of the adverse determination and should be mailed to: Attn:Chief Medical Officer, Fidelis Care, 95-25 Queens Blvd., 7th Floor, Rego Park, NY 11374.Claim correspondence mailing addresses:*Excludes New and corrected claims. ... Correspondence.Type*Product.More items...

Delegated Vendor Authorization Programs

Click to download provider tip sheets and follow links to Fidelis Care prior authorization submission resources.

Behavioral Health & Utilization Management

For Prior Authorization of Behavioral Health services, please see the following contact information:

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Need an Account?

View Patient Information, Get Claims Details, See Eligilibilty / Benefits, Submit Authorizations, and Download Provider-specific Documents.

LATEST NEWS

Fidelis Care is pleased to announce that we have 3 new inpatient prior authorization fax forms available on this site.

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Pharmacy Services

Formularies, utilization management programs, general pharmacy updates, and specialty drug programs.

Submit Authorization Requests

Utilization management systems available to submit authorization requests.