If you would like to receive Electronic Funds Transfer, please, FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Important Updates Regarding Coronavirus COVID-19, Health Care Eligibility Inquiry and Response (270/271) Companion Guide, Health Care Claim Status Request and Response (276/277) Companion Guide, Health Care Authorization Request and Response(278) Companion Guide, Health Care Benefit Enrollment and Maintenance (834) Companion Guide, Health Care Claim Payment/Advice (835) Companion Guide, Faster processing and reimbursement of clean claims, Reduction and/or elimination of the number of claims being rejected, Proof of timely submission through electronic acceptance reports, Sending and receiving claims documents electronically, The original claim number must be submitted, The claim frequency type code must be a 7 (replacement of prior claim), 2300 Loop, CLM Claim Information Segment, CLM05-3 Claim Frequency Type Code Element must be set to a 7 and 2300 Loop, REF Original Reference Number (ICN/DCN) Segment where REF01 Element equals F8, REF02 Element must contain Fidelis Care Original Claim Number, Only one correction for a Fidelis Care Original Claim Number should be submitted per day.

By clicking on these links, you will leave the Fidelis Care website. prior authorization when it is determined there is no participating provider with the appropriate training and experience to treat your condition. To help in this effort, please remember: Fidelis Care does not cover services by out-of-network providers, EXCEPT: In general, Fidelis Care will grantprior authorization when it is determined there is no participating provider with the appropriate training and experience to treat your condition. Starting June 1, 2021, there is no longer a monthly premium for Essential Plan coverage. Member Handbook Insert - Applied Behavior Analysis Services (PDF), Member Handbook Insert - Article 29-I Voluntary Foster Care Agency (VFCA) Health Facility Services (PDF), Member Handbook Insert - Behavioral Health Services for Children and Youth (PDF), Member Handbook Insert - Children and Family Treatment and Support Services (CFTSS) (Effective 1/1/20) (PDF), Member Handbook Insert - Children's Home and Community Based Services (PDF), Member Handbook Insert - Crisis Residence Services for Children and Adults (PDF), Member Handbook Insert - Family Planning Coverage (PDF), Member Handbook Insert - Infertility(PDF), Member Handbook Insert - Interoperability and Patient Access rule(PDF), Member Handbook Insert - Maximum Pharmacy Copay (Effective 4/1/20) (PDF), Member Handbook Insert - National Diabetes Prevention Program (NDPP) (Effective 2/1/20) (PDF), Member Handbook Insert - Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) (PDF), Member Notice - Smoking Cessation Counseling (Effective 11/1/2020)(PDF), Member Handbook Insert Behavioral Health Community Oriented Recovery and Empowerment (CORE) Services (Effective 4/1/2022), Member Handbook Insert - Children and Family Treatment and Support Services (CFTSS), Member Handbook Insert - Family Planning Coverage, Member Handbook Insert - Interoperability and Patient Access rule, Member Handbook Insert - Maximum Pharmacy Copay, Member Handbook Insert - National Diabetes Prevention Program (NDPP), Member Handbook Insert - Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST), Member Notice - Smoking Cessation Counseling, Member Handbook Insert - Important Updates Regarding Coronavirus COVID-19, Member Handbook Insert - New York Independent Assessor - Initial Assessment Process. Read the latest member newsletter and browse the archives. Fidelis Care can help. Q New York State law prohibits balance billing for emergency services received from an out-of-network provider or at an out-of-network facility. Submitting claims electronically leads to quicker payment of claims and saves costs in mailing. As part of the Interoperability and Patient Access Rule, you are now able to view your health information from a third party app on a mobile device or PC. These documents are also available in the Member Portal. Almost every child in New York State is eligible, regardless of family income or immigration status. Log in, register for an account, pay your bill, print ID cards, and more. The Member Handbook also explains how to get care using our provider network. Sometimes, Fidelis Care members atnetwork hospitals or ambulatory surgical centerswill receive health services fromproviders who donot participate in the Fidelis Care Network. Inicie sesin en su cuenta, vea la informacin de pacientes y ms. In this case, theresulting bill is NOT always considered a surprise bill. To learn more about Ability, call 1-888-499-5465 or visit. When balance billing isnt allowed, you also have the following protections: If you believe youve been wrongly billed, New York State Department of Financial Services. You can access your Summary of Benefits and Coverage, Subscriber Contract,and other important plan documentsby visiting our Member Resources page. You are admitted to the hospital. Thank you for your feedback. for more information or to register today. for more information on getting started, and preventive dental care best practices. Prior authorization is not approved for convenience. Once you know the health coverage you qualify for, you can: Tell us more about yourself to find qualifying plans and estimate costs. Questions about renewing health insurance? WellCare Medicare members should continue to use their WellCare ID card and visit the WellCare website and member portal. Para el pago con tarjeta de crdito,aceptamos Visa, Mastercard y Discover Card. We proudly welcome WellCare members to the Fidelis Care family, and look forward to serving you with the highest-quality care. FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Important Updates Regarding Coronavirus COVID-19. Note: If you go to a networkfacility, but receive care from an out-of-network provider, it's only a surprise bill if: It is NOTa surprise bill if you chose to receive services from a non-participating provider instead of from an available participating provider. Suicide Prevention Lifeline is available at 1-800-273-8255 and offers free and confidential crisis support available 24/7 to anyone at any time. We will contact you through your Member Portal email address. Visit our Davis VisionResource Pagefor information on getting started.

Log in, register for an account, pay your bill, print ID cards, and more. The answers you providewill help us serve you betterand get you connected to whatever services you may need. View and download documentsfor yourFidelis Care health plan. Apply to our provider network andbecome apart of the Fidelis Care mission. By clicking on these links, you will leave the Fidelis Care website. plan. FAQs and news concerning the COVID-19 coronavirus. Providers who wish to submit a dispute through the IDR Process for Surprise Bills and Emergency Servicesmust: Questions. Fidelis Cares Community Offices are open. FIDELIS CARE es una marca registrada de Centene Corporation, Despus de iniciar sesin en el Portal para Miembros, haga clic en el botn Billing and Payments (Facturacin y pagos). Navigate toCVS Caremarkfor more information or to register today.

By clicking on these links, you will leave the Fidelis Care website. Log into your account, view patient information, and more. Help is available for people in distress, crisis, or for people looking for resources for themselves or loved ones. Log in, register for an account, pay your bill, print ID cards, and more. When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Important Updates Regarding Coronavirus COVID-19, Department of Financial Services (DFS) website, When a request forprior authorization to seean out-of-network provider is approved, A participating provider was not available; or, A non-participating provider administered health services without your knowledge; or. Please use the links below to download the Companion Guide for the corresponding transaction: To receive 835 Electronic Remittance Advices for Fidelis Care claims, please contact your clearinghouse. Posted by Fidelis Care. The Member Portal is the easiest and most secure way to access information about yourplan. Your pharmacy benefits are covered through CVS Caremark. During the course of a visit with your networkprovider, an out-of-networkprovider treats you; or, Your participating providertakes a specimen from you in the office (for example, blood) and sends it to a non-participating laboratory or pathologist; or.

El pago en lnea es una forma rpida y fcil de realizar un pago SEGURO de su prima mensual de Fidelis Care. Member Services DepartmentFidelis Care25-01 Jackson AvenueLong Island City, NY 11101. Child Health Plus covers prescription or non-prescription drugs listed in the formulary with no cost-sharing as long as they are ordered by a providerwithin the Fidelis Care network. of Neurosurgery, Saratoga and Warren County (excluding Glens Falls Hospital), Saratoga Hospital, OrthoNY, Hudson Headwaters Health Network, Adirondack Pediatrics, Schenectady County and Albany County, ZIP Codes include: 12009, 12023, 12077, 12084, 12107. This Summary will remain posted on our website, for a minimum of 30 calendar days from the date of our letter. q The Unity Hospital and Unity PCP sites, Rochester General Hospital (Unity, Clifton Springs, Newark-Wayne, United Memorial Medical Center), GRIPA. FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Important Updates Regarding Coronavirus COVID-19. Electronic Submission of Corrected Claims. For members with pharmacy coverage, your benefits are covered through CVS Caremark. Log into your account, view patient information, and more. Help is available for people in distress, crisis, or for people looking for resources for themselves or loved ones. Search for a medical professional, service, or facility in the Fidelis Care Network. To submit prior authorization request types, use the Fidelis Care provider portal. Call 1-888-FIDELIS;(1-888-343-3547); TTY: 711. Log in, register for an account, pay your bill, print ID cards, and more. Log into your account, view patient information, and more. Call 1-888-FIDELIS (1-888-343-3547); TTY: 711. By clicking on these links, you will leave the Fidelis Care website. Log in, register for an account, pay your bill, print ID cards, and more. To enroll, please call Availity Client Services at 1-800-AVAILITY (1-800-282-4548). Once your payment is processed, we will send your Member ID Card and welcome materials, which should then take 7-10 business days to arrive. Log in or register to makepayments, print ID cards, choose or change a PCP, and much more. With 24/7 access to your Fidelis Care account, you can pay your monthly premium,request and print new ID cards, and access your plan documents. Find doctors who participate with your plan using our Find a Doctor tool. To create a secure online member account, visit. Log in, register for an account, pay your bill, print ID cards, and more. HealthierLife Health and Recovery Plan (HARP), Fidelis Care at Home (Managed Long Term Care). Este servicio est disponible las 24 horas del da, los 7 das de la semana, los 365 das del ao. With 24/7 access to your Fidelis Care account, you can pay your monthly premium. To learn more about HIPAA and your privacy rights, visit theU.S. Department of Health and Human Services. Information to help you and your provider better manage your health. For members with vision coverage, your benefits are covered through Davis Vision. Please let us know what you need help with. News you can use to live healthier and get the most out of your health insurance! TheSummary of Benefits and Coverageoutlines some of your plans key benefits, and explains how much they couldcost. Need more help? For members with dental coverage, yourbenefits are covered through DentaQuest. Posted by Fidelis Care. for information about pharmacy and utilization management procedures, specific benefit inclusions and exclusions, and to learn how to get care using our provider network. Log into your account, view patient information, and more. Fidelis Care offerscase management servicesto members by phone. Unforeseen medical circumstances arose at the time the healthcare services were provided. If you are a member of a WellCare Medicare plan, this change does notaffect you. By clicking on these links, you will leave the Fidelis Care website. Tompkins County, ZIP Codes: 13053, 13062, 13068, 13073, 13102, 13736, 13864, 14817, 14850, 14851, 14852, 14853, 14854, 14867, 14881, 14882, 14883, 14886, Asthma and Allergy Associates, Northeast Pediatrics and Adolescents, Buttermilk Falls Peds, Dryden Family Medicine, Cayuga Area Plan, Cayuga Medical Center, Family Health Network (FHN), All ECPO Providers, Cortland Regional Hospital, UHS, United Health Services Systems, Bronx County, ZIP Codes: 10451, 10452, 10453, Bronx County, ZIP Codes: 10454, 10455, 10456, 10457, 10458, 10459, 10460, 10472, 10473, 10474, Acacia Network , Essen Medical Associates, PC, MedAlliance Medical Health Services, Morris Heights Health Center, Urban Health Plan, Lincoln Medical Center, Bronx County, ZIP Codes: 10461, 10462, 10463, 10464, 10465, 10466, 10467, 10468, 10469, 10470, 10471, 10475, Bronx Lebanon Hospital, Calvary Hospital, Kings County (Brooklyn), ZIP Codes: 11234, 11210, 11236, 11239, 11218, Kings County, ZIP Codes: 11201, 11205, 11206, 11211, 11217, 11222, 11226, 11231, 11243, 11249, 11237, WoodHull Medical Center, Maimonides, Wyckoff Medical Center, SUNY Downstate, ICL, Brownsville Medical Center, Brooklyn Hospital, NY Community Hospital, NY Methodist Hospital, CityMD, Kings County, ZIP Codes: 11204, 11209, 11214, 11228, 11230, 11232, Kings County, ZIP Codes: 11207, 11208, 11239, 11212, 11203, 11220, Kings County, ZIP Codes: 11213, 11215, 11216, 11217, 11221, 11225, 11231, 11232, 11233, 11238, Brookdale Hospital, Interfaith Medical Center, Kingsbrook Jewish Medical Center, Planned Parenthood, Kings County, ZIP Codes: 11235, 11224, 11223, 11229, 11219, Manhattan, ZIP Codes: 10001, 10018, 10019, 10036, Assigned Accounts: Mt Sinai Elmhurst Faculty Practice Group (6169), Mt Sinai Queens Faculty Group (6162), William F. Ryan CHC, Ryan Chelsea Clinton CHC, Ryan Nena CHC, AdvantageCare Physicians, PC, Manhattan, ZIP Codes: 10002, 10003, 10009, 10010, 10016, 10017, 10021/10065, 10022, 10028, 10044, 10075, 10128, Manhattan, ZIP Codes: 10004, 10005, 10006, 10007, 10011, 10012, 10013, 10014, 10038, 10048, 10279, 10280, 10282, Manhattan, ZIP Codes: 10020, 10023/10069, 10024, 10025, Beth Israel Medical Center - Mt Sinai, St. Luke's Roosevelt Hospital - Mt Sinai, New York Eye and Ear infirmary - Mt Sinai, South Nassau Community Hospital, Mount Sinai Hospital, Mount Sinai Health System, Manhattan, ZIP Codes: 10026, 10027, 10029, 10030, 10031, 10032, 10033, 10034, 10035, 10037, 10039, 10040, Nassau County, ZIP Codes: 11001, 11020, 11021, 11023, 11024, 11030, 11040, 11042, 11050, 11501, 11507, 11514, 11530, 11542, 11545, 11548, 11560, 11568, 11576, 11577, 11579, 11590, 11596, 11714, 11732, 11735, 11753, 11771, OncoMed Pharmaceutical Service, Nassau University Medical Center, Nassau County, ZIP Codes: 11096, 11509, 11510, 11516, 11518, 11520, 11550, 11552, 11553, 11554, 11555, 11557, 11558, 11559, 11563, 11565, 11566, 11570, 11572, 11575, 11580, 11581, 11598, 11709, 11710, 11756, 11758, 11762, Mercy Medical Center (CHS), St. Joseph Hospital (CHS), St. Francis Hospital (CHS), Queens, ZIP Codes: 11004, 11354, 11355, 11356, 11357, 11358, 11360, 11361, 11362, 11363, 11364, 11365, 11366, 11367, 11411, 11412, 11413, 11416, 11417, 11419, 11420, 11423, 11426, 11427, 11428, 11429, 11432, Queens, ZIP Codes: 11101, 11102, 11103, 11104, 11105, 11106, 11368, 11369, 11370, 11371, 11372, 11373, 11418, 11436, 11691, 11692, 11693, 11694, 11697, Elmhurst Hospital, Queens Hospital Center, Queens, ZIP Codes: 11374, 11375, 11377, 11378, 11379, 11385, 11414, 11415, 11421, 11422, 11430, 11433, 11434, 11435, Assigned Accounts: Dr Nodar Katz (11435), South Island Medical Associates P.C (11691), Sinai I, Inc. (11691), Rockland County, ZIP Codes: 10911, 10920, 10923, 10927, 10931, 10956, 10970, 10974, 10980, 10901, 10982, 10984, 10986, 10992, Good Samaritan Hospital/Bon Secours, Refuah Health Center, Rockland County, ZIP Codes: 10913, 10952, 10954, 10960, 10962, 10964, 10965, 10968, 10976, 10977, 10983, 10989, 10994, Helen Hayes Hospital, Community Medical and Dental Care. 0 Visit the DentaQuest website(by clicking on this link, you will leave the Fidelis Care website) for more information or to register. Log into your account, view patient information, and more. Visit fideliscare.org/costcalculator to find a treatment costcalculator, providing you with estimates that cover other conditions and services. Certain services at an in-network hospital or ambulatory surgical center. Some of our health plans require you to have a PCP, while others do not. Read the CHP Subscriber Contract for information about pharmacy and utilization management procedures, specific benefit inclusions and exclusions, and to learn how to get care using our provider network. FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Important Updates Regarding Coronavirus COVID-19. FIDELIS CARE and the FIDELIS CARE LOGO are registered trademarks of Centene Corporation. You do not have to pay non-participating provider charges for emergency services (typically for services in a hospital emergency room) that are more than your in-network copayment, coinsurance or deductible. To request a paper copy, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547); TTY: 711. We are proud to be your healthcare partner and want tohelp youaccess essential health benefits and services to keep you ashealthy as possible.

Tenga a mano su ID de Confirmacin de NY State of Health. The cost examples are estimates only,and serve as a guide for how your particular plan might cover different conditions; not theexact dollar amount you will pay. An error has occured while processing your request. General Statement of Member Rights and Responsibilities (PDF), Personal Health Information Disclosure Form (PDF). If you need information about claims or payments prior to June 1, 2020, please visit the WellCare member portal. With 24/7 access to your Fidelis Care account, you can pay your monthly premium,request and print new ID cards, and access your plan documents. No need to wait for open enrollment: You can enroll in Medicaid Managed Care year-round.

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