The Fidelis Care Blog

Effective November 1, 2025, Fidelis Care will begin outreaching for additional clinical information if a member remains hospitalized beyond seven (7) days. This outreach will initiate a concurrent review to assess medical necessity and support discharge planning activities.

The following sections of the Fidelis Care authorization grids have been updated effective November 1, 2025.

Effective October 1, 2025, Ambetter from Fidelis Care will implement a Site of Care Optimization Program to promote cost-effective, high-quality care for members receiving infusion therapies.

The role of primary care providers in preventing vaccine-preventable diseases includes more than administering vaccines. Timely documentation in New York’s immunization registries (New York State Immunization Information System (NYSIIS) for providers outside New York City, and the Citywide Immunization Registry (CIR) for providers within New York City) is essential to protecting children and supporting public health.

In today’s healthcare landscape, effective coordination between primary care providers (PCPs) and specialists is essential for delivering safe, timely, and patient-centered care.

LONG ISLAND CITY, NY (October 23, 2025) Fidelis Care, a statewide health plan with more than 2.4 million members in New York State and a Centene Corporation company, today announced the launch of its new Here for Your Health (HFYH) campaign, reaffirming its commitment to the health and well-being of every New Yorker. The campaign highlights Fidelis Care’s mission to ensure individuals receive care that is accessible, personalized, and comprehensive at every stage of life. Through strategic partnerships and community-based outreach, HFYH aims to connect New Yorkers with essential health services and resources that support physical, mental, and emotional well-being, while actively working to bridge gaps in care across communities.

As we approach the final quarter of the year, we’re entering a critical phase of the Continuity of Care (CoC) program. Our shared goal remains clear: to ensure patients receive timely, high-quality care while closing the most impactful clinical gaps by December 31.

Fidelis Care will host three Provider Office Hours in November 2025. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.

When someone you care about finds out they have breast cancer, it can be scary and confusing—for them and for you. You might not know what to say or how to help. But just being there for them can make a big difference. Here are some simple and kind ways to support a loved one during this tough time.

Fidelis Care would like to remind providers of a postpartum visit incentive being offered through the New York State (NYS) Medicaid program and inform providers of extended claim submission dates.