Fidelis postpartum form 2026

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The document is a Postpartum Encounter Form for the BabyCare Program, which providers must complete and submit to Fidelis Care after a member's postpartum visit (21 to 56 days post-delivery). It includes sections for member and provider information, visit details, and identifies postpartum issues. Completing the form qualifies providers for a $200 incentive, with submission deadlines outlined.

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Click ‘Get Form’ to open the fidelis postpartum form in the editor.
Begin by filling in the Group Name and Provider Name at the top of the form. Ensure that all fields are completed accurately.
Enter the Tax Identification Number, which is mandatory for processing. This ensures your submission is linked correctly.
Fill in the Member's details: Name, ID Number, Phone Number, Date of Birth, Date of Delivery, and Estimated Due Date (EDC). Double-check these entries for accuracy.
In the Postpartum Visit section, provide the date of the visit and weight. If applicable, indicate if there was a no-show.
Check all relevant boxes for exams conducted during the visit and note any postpartum issues identified.
Select whether breastfeeding or bottle feeding was discussed. Finally, ensure both provider signature and date are included before submission.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (177 Votes)
2016	4 Satisfied (35 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the phone number for Fidelis Care provider?

Wellcare By Fidelis Care offers a range of Medicare plans to provide members with affordable access to the same great network of doctors, nurses, and specialists.

Does Fidelis Care cover pregnancy?

Fidelis Care offers free online claims submission through Inovalons claims portal. To learn more about Inovalon, call 1-888-499-5465 or visit .mdon-line.com/fideliscare. You also have the option to contact another clearinghouse to initiate 837-claim submission to Fidelis Care.

How do I speak to a Fidelis representative?

Our Representatives can answer your questions and assist you by phone. Call 1-888-FIDELIS; (1-888-343-3547); TTY: 711.

Is Fidelis Care New York Medicaid?

Support for Your Office If you have any Provider Access Online questions, or need help registering, check with your account administrator , contact your Fidelis Care Provider Relations Specialist, or connect with our Call Center at 1-888-FIDELIS (1-888-343-3547).

How do I file a claim with Fidelis?

(888) 343-3547 Fidelis Care / Customer service

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