Does Fidelis require a referral?

Does Fidelis require a referral?

Your PCP or plan provider must ask Fidelis Care for approval before you can get an out-of-network referral. You or your PCP can call Member Services at 1-888-FIDELIS (1-888-343-3547).

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.

Is Medicaid and Fidelis the same?

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.

Does Fidelis cover specialists?

Fidelis’ Member Services Department will assist you and your PCP in finding the appropriate specialist to provide the medically necessary care to treat your condition. Asking to see an out-of-network specialist is a service authorization request.

Do you need referral for specialist?

No referrals necessary You can make appointments with specialists without having to first get a referral from your PCP.

What is the phone number for Fidelis Care?

1 (888) 343-3547
Fidelis Care/Customer service

Does Fidelis cover gastric bypass?

7. Does my insurance cover the surgery? Generally, these services are covered by insurance, including Medicare, Medicaid, Medicaid managed care (such as MetroPlus, Healthfirst, or Fidelis), and private insurance plans.

Can patients submit prior authorizations?

Some plans allow patients to file their own prior authorizations, but most often this is a process that must be initiated with the doctor’s office. Often your doctor will have an idea if the healthcare you need is likely to require this extra step.

Is Fidelis Medicare or Medicaid?

Fidelis Care is contracted with Medicare for HMO, HMO D-SNP, and HMO-POS plans, and with the state Medicaid program. Enrollment in Fidelis Care depends on contract renewal.

How much does Fidelis cover for therapy?

When you see a therapist who is in-network with Fidelis Care, each session you’ll pay only a copay, which typically ranges from $0-$75/session. Fidelis Care is a common health insurance in New York, and individuals who have Fidelis Care may wish to find therapists who are in-network with their health insurance.

How do I submit a request to Fidelis Care?

Email: [email protected] For Provider Manuals, Forms and Policies (Including Behavioral Health Request Forms), please click here . To submit prior authorization request types, use the Fidelis Care provider portal. Formularies, utilization management programs, and specialty drug programs.

Why choose Fidelis Care?

Fidelis Care provides quality, affordable health insurance coverage to more than 1.7 million people of all ages and at all stages of life in New York State. Fidelis Care | Quality, Affordable Health Insurance

Does Fidelis Care have new Medicare plans in 2021?

Many of Fidelis Care’s offices have reopened, following all state and local guidelines. By appointment or walk-in, you can get answers to all your health insurance questions. Fidelis Care offers new Medicare Advantage and Dual Advantage plans in 2021. Our representatives can answer your questions and help you choose the plan that’s right for you.

Does Fidelis Care work with National Imaging Associates?

As previously announced, Fidelis care is pleased to share we are expanding our partnership with National Imaging Associates, Inc. (NIA) to provide utilization management for outpatient rehabilitative and habilitative physical medicine services for Fidelis Care’s Medicare members.

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