Get Fidelis Baby Care Program

The Fidelis Baby Care Program is designed to assist users in documenting and submitting crucial information regarding postpartum care. This guide provides clear and concise steps to help you complete the program's online form effectively.

Follow the steps to complete the Fidelis Baby Care Program form online.

1. Click ‘Get Form’ button to access the necessary document for the Fidelis Baby Care Program.
2. Fill out the provider's name and group name in the designated fields.
3. Enter the tax identification number (TIN) in the specified section; this field is mandatory.
4. Provide the member's name, ID number, and phone number in the corresponding fields.
5. Record the member's date of birth and the date of delivery accurately.
6. In Section I, input the dates of prenatal visits, ensuring each visit meets the required frequency outlined in Table C. Each entry must include specific checkboxes for the pelvic exam, fetal heart tone, and fundus height.
7. For Section II, enter the postpartum visit date, ensuring it falls between 21 to 56 days post-delivery. Note any no-show status and weight in the provided sections.
8. Select applicable checkboxes for postpartum evaluations such as pelvic, abdominal, and breast exams. Additionally, list any postpartum issues identified and specify feeding methods.
9. The provider must sign and date the form, confirming all information is complete and accurate.
10. Once you have filled out all required fields, you may save changes, download, print, or share the form as necessary.

Complete your Fidelis Baby Care Program form online today.