Fidelis Care billing and credentialing
Billing and credentialing for Fidelis Care plans in New York.
Working with Fidelis Care
Fidelis Care serves New York members through Medicaid managed care, Child Health Plus, the Essential Plan, Marketplace and Medicare plans.
Plan types we bill:
- Medicaid Managed Care
- Child Health Plus
- Essential Plan
- Marketplace and Medicare plans
Credentialing and enrollment
For Medicaid products, you must first be enrolled with the state Medicaid agency, then credentialed with the plan.
Credentialing uses your CAQH ProView profile, which must be complete and re-attested every 120 days.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Fidelis Care has its own provider portal and follows New York State Medicaid rules for Medicaid products.
Denials we prevent with Fidelis Care
- Provider enrolled with the state but not credentialed with the plan
- Member assigned to a different plan this month
- Missing plan prior authorization
- Behavioral health or vision carved out to another vendor
- State-specific coding or modifier rules not followed
Questions about Fidelis Care
Do you bill New York Medicaid plans like Fidelis?
Yes, including New York-specific Medicaid rules.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Fidelis Care claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.