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HomeMemberHelpful ToolsHealth ResourcesHeart Disease

Heart Disease Resources

People of all ages need to keep their heart healthy. Eating well, exercising regularly, and seeing your health care provider can help you keep your heart healthy. Work with your healthcare provider and adopt good lifestyle habits to help lower the risk of heart disease.

Heart disease describes conditions related to plaque building up in the walls of the arteries. Other conditions include arrhythmia (abnormal heart rhythms), congenital heart failure, and heart valve problems.

What is your risk?

Heart disease can happen to anyone, including children. You can be born with it, and a family history of heart disease may increase your risk.

Most heart disease develops over time due to poor habits such as smoking or eating an unhealthy diet. Having high cholesterol, high blood pressure, or diabetes also increases your risk of heart disease. Talk with your provider about ways to prevent or manage diabetes and control other risk factors.

What is a good resting heart rate?

A normal resting heart rate for adults ranges from 60 to 100 beats per minute (bpm). Remember, factors such as age, physical activity, and overall health can affect what is considered your normal resting heart rate.

Talk to your provider if you have concerns about your heart rate.

How does high blood pressure affect heart health?

The higher your blood pressure levels, the more risk you have for heart disease, heart attack, and stroke. Causes for high blood pressure include:

  • Diabetes
  • Being overweight or obese
  • Smoking
  • Not getting enough regular physical activity
  • Unhealthy diets, including high amounts of sodium and alcohol

Talk to your provider about how you can lower your blood pressure to help avoid heart disease and stroke.

How can you lower your risk of heart disease?
• Eat plenty of fruits, vegetables, whole grains, nuts, poultry, and fish; avoid having too much salt or sugar
• Maintain a healthy weight
• Exercise at least 150 minutes per week
• Keep your blood pressure, cholesterol, and blood sugar at a healthy level
• Don’t smoke or use any tobacco products
• Follow your doctor’s recommendations
Can heart disease be treated?
Yes. Talk to your provider about how to safely reduce the risk of heart disease. You can also talk about setting goals for a healthier heart. Your provider may also prescribe medication.
What are symptoms of a heart attack?

A heart attack occurs when the flow of blood to the heart is severely reduced or blocked. Be aware of the following symptoms:

  • Fatigue
  • Cold sweat
  • Nausea
  • Chest pain
  • Dizziness
  • Shortness of breath
  • Pain in the jaw, neck, arms, shoulder, or back

Call 911 if you or someone you know is having a heart attack.

What can cause Congestive Heart Failure?

Congestive heart failure (CHF) is a chronic condition that makes it harder for your heart to pump blood and meet your body's needs. The following factors may increase your risk of CHF:

  • Diabetes
  • High cholesterol levels
  • High blood pressure
  • Poor diet
  • Not getting enough physical activity
  • Smoking and/or using tobacco
  • Being overweight or obese
  • Stress

Talk to your provider to learn more about CHF.

What can cause heart arrhythmia?

A heart arrhythmia is an irregular heartbeat. Factors that may cause arrhythmia include:

  • Blood sugar levels that are too low or too high
  • Caffeine, illegal drugs, and certain medications
  • Dehydration
  • Low levels of electrolytes, such as potassium, magnesium, or calcium
  • Physical activity
  • Strong emotional stress or anxiety
  • Vomiting or coughing
  • Smoke
  • Use illegal drugs, such as cocaine or amphetamines
  • Drink alcohol more often and more than is recommended (no more than 2 drinks per day for men and 1 drink per day for women)
  • Take certain antibiotics and over-the-counter allergy and cold medicines

Talk to your provider about how to prevent arrhythmias.

Here are some resources to help you prevent or manage heart disease:

 

Managing Blood Pressure Flyer

American Heart Association

 High Blood Pressure Resources Page (CDC)

Heart Health Articles and Videos (Healthwise)

 

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Fidelis Care Remittance Advice CARC/RARC Codes
5/2/2024 • Posted by Provider Relations

Fidelis Care would like to inform providers about upcoming changes to our remittance advice.  Effective May 12, 2024, the Fidelis Care remittance advice will include Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC), along with a description of the codes.

 

CARCs describe why a claim or service line was paid differently than it was billed and RARCs provider additional explanation for an adjustment already described by a CARC or convey information about remittance advice. 

 

There are two types of RARCs, supplemental and informational.  The majority of RARCs are supplemental; these are generally referred to as RARCs without further distinction.  Supplemental RARCs provide additional explanation for an adjustment already described by the CARC.  The second type of RARC is informational; these RARCs are all prefaced with “Alert”. Alerts are used to convey information about remittance processing and are never related to a specific adjustment or CARC.

 

Sample of Applicable CARC and RAC Codes found on a Remittance Advice:

 

Explanation

Code

CARC/RARC Code

Description

K09

97/ N70

CARC: The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.

RARC: Consolidated billing and payment applies.

K03

97

CARC: The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.

Z03

23/N377

CARC: The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)

RARC: Payment based on a processed replacement claim.

BHX

45/ N860

CARC: Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.

RARC: Alert: The Federal No Surprise Billing Act Qualified Payment Amount (QPA) was used to calculate the member cost share(s).

B95

226/ M143

CARC: Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete. 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: The provider must update license information with the payer.

i19

252/ N350

CARC: 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: Missing/incomplete/invalid description of service for a Not Otherwise Classified (NOC) code or for an Unlisted/By Report procedure.

 

 

If you have any questions, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please click here.