Fidelis Care
Fidelis Care is a payer organization operating in New York. For an ASC, what matters isn't the logo. It's how Fidelis Care pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Fidelis Care analysis
Tell us where to send it. Our team will prepare an analysis of Fidelis Care covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Fidelis Care pays
See how Fidelis Care reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Fidelis Care's presence spans New York. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Fidelis Care and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Fidelis Care's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Fidelis Care up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Fidelis Care
- Payer ID
- 11315 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Fidelis Care through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Fidelis Care members are verified before the date of service, through a clearinghouse using payer ID 11315or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Fidelis Care directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Fidelis Care the way it pays.
- What is Fidelis Care's payer ID?
- Fidelis Care's electronic payer ID is 11315. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Fidelis Care through a clearinghouse.
- How do ASCs verify eligibility for Fidelis Care members?
- Eligibility and benefits for Fidelis Care members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 11315) or through the payer's provider portal.
- Does Fidelis Care require prior authorization for ASC procedures?
- Prior-authorization requirements for Fidelis Care are set per plan and per procedure. Confirm whether an authorization is required with Fidelis Care directly before the date of service.
- What type of payer is Fidelis Care?
- Fidelis Care is a payer organization operating in New York.
- How does Fidelis Care compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Fidelis Care pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Fidelis Care paying my ASC below market?
- Put your own Fidelis Care contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.