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HomeAbout usHealth EquityHealth Equity Alt

Health Equity

At Fidelis Care, we believe everyone should have the opportunity to live a healthy life. It’s our mission to ensure New Yorkers have access to high-quality healthcare, so they can get the care they need when they need it.

But many other factors contribute to an individual’s health and wellness beyond access to healthcare. Socioeconomic conditions can influence health risks and outcomes. Poverty, food insecurity, housing instability, education, employment, access to transportation and other circumstances contribute to health disparities among underserved and vulnerable populations.

Fidelis Care is committed to removing those barriers to health to improve access, quality, and affordability. It is an ongoing process that requires working together with our members, providers, and community-based organizations to support fair and just opportunities to equal access to healthcare.

Learn more about our different approaches to improve health equity:


Key partnerships

Wellness commitment to Buffalo Urban League

To nurture social entrepreneurship, facilitate wellness, and strengthen organizations focused on Black, Indigenous and People of Color in Buffalo’s East Side, Fidelis Care and the Centene Foundation donated $1.1 million to the Buffalo Urban League (BUL) to help establish its new headquarters and develop a Wellness and Entrepreneurial Center.

In addition, Fidelis Care partners with BUL through community programs and at events held in the city focused on health, family support and stabilization services, foster care, adoption, education, job training, employment, scholarships, and more.

Buffalo-Urban-League

Mental health alliance with The Jed Foundation

As part of our behavioral health efforts, Fidelis Care and the Centene Foundation awarded $1.1 million to The Jed Foundation (JED) to protect the mental health of New York State’s youth.

Through the funding, JED will expand its current services, providing at least five youth-serving community-based organizations (CBOs) with consultation or strategic planning services, including expert guidance, educational workshops, and training programs, equipping young people with life skills and connecting them to mental healthcare when they are in distress.

Fidelis-JED-Social


More Health Equity News


New EOB Reason Code for Claim Adjustments
8/1/2025 • Posted by Provider Relations in Provider News

Fidelis Care would like to announce a new Explanation of Benefit (EOB) adjustment reason code that will be applied to claims where Fidelis Care has received a primary carrier payment.

New EOB Reason Code Details:

  • CARC Code: 216 – Based on the findings of a review, organization or the payer’s findings.
  • RARC Code: N199 – Additional payment/recoupment approved based on payer-initiated review/audit.
  • These are internal adjustments that reflect the primary carrier’s payment. They do not impact the provider’s Remittance Advice financially and are not considered recoupments.

 

Primary Carrier Billing and Payments:

Medicaid is the payer of last resort and should always be billed after all other insurance carriers.  Fidelis Care partners with vendors, such as HMS, to identify previously paid claims that were the responsibility of another carrier.  

  • When it is identified that Fidelis Care Medicaid paid out of order, the vendor outreaches and obtains payments directly from the appropriate carrier.
  • The payments from the appropriate carrier are then posted to the claim in the Fidelis Care system as an internal adjustment. 
  • There is no impact to the provider’s payment from Fidelis Care. 
  • The CARC/RARC codes identified above will show on the EOB when this process occurs.

 

If you have any questions, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.