The Fidelis Care Blog

History is made of fine details that form a much larger picture. These intricate lines and strokes shape who we are. February commemorates the rich Black history that has allowed me to stand in my achievements today. This month reminds me of my mission: to pour into my community.

Fidelis Care is committed to strengthening our partnership with providers and enhancing the overall experience when addressing claims related concerns. As part of this ongoing effort, we are introducing a new Fidelis Care Claims Inquiry Template, which will be required beginning March 1, 2026 for all claims inquiries submitted after the standard appeals process has been completed.

Fidelis Care would like to remind our provider community of the required protocols for submitting corrected claims and to clarify how these differ from appeals. Following these guidelines helps ensure timely and accurate claims processing.

The New York State (NYS) Department of Health has applied to participate in the federal Centers for Medicare and Medicaid Services (CMS) Cell and Gene Therapy (CGT) Access model.

Fidelis Care would like to inform providers that evaluation and management (E&M) services billed on a facility claim with treatment room revenue codes are not eligible for reimbursement. Evaluation and Management procedure codes represent the professional service – the physician or qualified provider’s time, assessment and decision- making.