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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 DRG Claim Review Initiative – Effective September 1, 2025
8/1/2025 • Posted by Provider Relations in Provider News

As part of our ongoing Payment Integrity Program, a new initiative will begin September 1, 2025. This program involves review of the medical records associated with an identified inpatient claim to ensure that the documentation in the medical record fully supports the diagnosis and procedure codes that were billed.

 

What to Expect:

  • Claims selected for review will be reflected as denied on the Remittance Advice with reason code 602 – Medical record required for DRG validation.
    • CARC - 252 - An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).
    • RARC - M127 - Missing patient medical record for this service.
  • You will receive a letter from Cotiviti requesting the medical records related to the denied claim(s).
  • The letter will specify the required documentation needed to complete the review and the timeframe for submission.

 

Lines of Business Impacted:  All

 

Action Required:

  • Please submit the requested medical records within 60 calendar days of receiving the Cotiviti letter.
  • Timely submission is essential to ensure a timely and efficient review of the claim.

 

Additional Information:

 

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.