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.

Fidelis Care Authorization Grids Effective November 1, 2025

9/29/2025 • Posted by Provider Relations

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

9/29/2025 • Posted by Provider Relations

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.

Strengthening Immunization Practices: The Importance of Timely Reporting and Scheduling

9/29/2025 • Posted by Provider Relations

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.

The Critical Role of Care Coordination Between PCPs and Specialists

9/29/2025 • Posted by Provider Relations

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

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