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Provider Quality

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To ensure a continued focus on quality, Fidelis Care is dedicated to engaging with providers to ensure our members get the best care possible. Quality is a critical component of the work we do at Fidelis Care. The Provider Relations Department works diligently to support providers in quality improvement initiatives.


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Provider Quality News


4/29/2025 • Posted by Provider Relations • in Provider News
Due to regulatory requirements defined in Article 44 of the New York State Public Health Law for all Managed Care Organizations (MCO), Fidelis Care is implementing changes to our Utilization Management/Authorization Appeals process. Effective June 1, 2025, Fidelis Care will require providers to adhere
4/28/2025 • Posted by Provider Relations • in Provider News
The following section of the Fidelis Care authorization grids have been updated effective June 1, 2025.
4/23/2025 • Posted by Provider Relations • in Provider News
Fidelis Care would like to remind providers of the updated calculation of hospitals’ initial inpatient acute, exempt hospital, and exempt unit reimbursement rates for Medicaid Fee-for-Service (FFS) and Medicaid Managed Care (MMC), which were effective October 1, 2024.
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Provider Office Hours

Fidelis Care hosts webinars called “Provider Office Hours” several times each month to share information and answer any of your questions. 

Provider Satisfaction Survey

Your provision of quality care and services to our members contributes greatly to Fidelis Care’s success. One of the ways Fidelis Care prioritizes quality is making sure you are satisfied with your experiences. Our annual Provider Satisfaction Survey identifies areas to focus on for further improvement in the coming year. The Provider Relations Department works diligently to identify an action plan to address areas of improvement, while continuing to develop actions and interventions to improve the provider experience.

HEDIS® Measurement Year 2025 Toolkit

HEDIS® is a tool used by more than 90% of America’s health plans to measure performance on important dimensions of care and service. We've developed this toolkit to help identify required preventive services.


Resources

Fidelis Care offers resources including Provider Bulletins, tip sheets, educational materialsblog posts, and more to keep you informed.

 

CURRENT PROVIDER BULLETIN

  • Help Prevent the Flu: Encourage Vaccination
  • COVID-19 Reminder
  • Cardiovascular Disease and Statin Therapy
  • Antibiotic Stewardship Starts with Awareness
  • CDC Recommendations for STI Treatment