Interactive Voice Response Application for Checking Claim Status
Fidelis Care’s Interactive Voice Response (IVR) application is now available for checking claim status. This service is available 24/7 and quickly and easily allows you to retrieve information about your claims with no hold or wait time! You can access this application by calling 1-­‐888-­‐
FIDELIS (1-­‐888-­‐343-­‐3547) and following the prompts for “claim status”. From here, you can obtain basic information about your claim such as claim status, paid amount, member responsibility, etc. For complete claim details, providers can also visit Provider Access Online at providers.fideliscare.org. Information Needed to Check Claim Status Upon entering the claim status menu option, you will be asked to enter the following information to obtain claim status: § Employee Identification Number (EIN) or Tax Identification Number § Fidelis Care Member Identification Number § Member’s Date of Birth (format must be -­‐ XX/XX/XXXX) § Date of Service (format must be -­‐ XX/XX/XXXX) If there is a claim match within the Fidelis Care system, the information below will be returned. If there is not a match or if the search produced too many results, callers will have the option to: press 1) to search claims for a different date of service for this member; press 2) to search claims for a different member; press 3) to search for claims for a different provider; or press # return to the previous menu. Claim Information Returned § Fidelis Care claim number § Receive date § Total amount billed § Date the claim was complete § Allowed amount (amount paid) § Disallowed amount (the difference between the billed charges and allowed amount) § Member responsibility Following the claim details above, callers will have the option to: press 1) to search another DOS for this member; press 2) to search claims for a different member; press 3) to search claims for a different provider; or press # to return to previous menu options.