Summary
Fidelis Care is a Medicaid managed care organization, part of Centene (WellCare, Ambetter, subs), offering dental and medical coverage operating in 32 states. Claims route under payer ID 11315, with 9 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-120 days, with applications through State-specific subsidiary portals, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.
At a glance
- Payer ID
11315Also seen as 00414, 10459, 11315MA, 11315MC, 3792, 6536 and 3 more- Also known as
- Ambetter from Fidelis Care, Centene Corporation, Essential Plans, Fidelis Care New York, New York Quality Healthcare Corporation
- Uses CAQH
- YesApplication route: Portal or paper application
- Service area
- 30+ states via subsidiaries
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Not required | Immediate |
| Claim status (276/277) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | Several weeks |
Common questions
- What is the payer ID for Fidelis Care?
- The payer ID for Fidelis Care is 11315. Alternate IDs seen across clearinghouses include 00414, 10459, 11315MA, 11315MC.
- How long does Fidelis Care provider enrollment take?
- Fidelis Care provider enrollment typically takes 60-120 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
- Does Fidelis Care require CAQH?
- Yes. Fidelis Care uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
- Does Fidelis Care require ERA enrollment?
- Yes. Fidelis Care requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
- What states does Fidelis Care cover?
- Fidelis Care operates in 30+ states via subsidiaries. Coverage can differ by plan and product line, so confirm the specific plan before you file.
Related payers
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.