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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.


Hearthands

If you have any questions, please contact your Quality Improvement Specialist.

Quality Improvement Specialists
NYC Region:

Name Coverage Area Assigned Counties and/or Providers
Brianni Blue Loftlin 

✉ Email Address

Brooklyn County: 11201, 11203, 11205, 11206, 11207, 11212, 11217, 11211, 11213, 11221, 11226, 11220, 11237, 11238, 11239, 11243, 11249 Brooklyn County
 Yen Min Yau

✉ Email Address

ZIP Codes: 11220, 11204, 11214, 11229 Kings County

Providers: CAIPA & Excelsior Empire Health Brooklyn Providers
 Zinaida Khavasova

✉ Email Address

Kings County: 11219, 11223, 11224, 11229, 11235, 11230, 11204, 11209, 11214, 11228, 11232, 11210,11239, 11218 Kings County

Providers: Maimonides, One Brooklyn Health System: (Interfaith, Brookdale and Kingsbrook) 
 Michael Gayle

✉ Email Address

All ZIP Codes in the Bronx except for providers/groups assigned to an IPA (Balance, Bronx United) Bronx County

Providers: Boston Children's Health Physicians (Westchester County), Northwell (All Affiliated TINs) 
 Stanley Laforest

✉ Email Address

ZIP Codes: 10003, 10004, 10005, 10006, 10007, 10009, 10010, 10011, 10012, 10014, 10016, 10017, 10018, 10019, 10020, 10021, 10022, 10023, 10024, 10025, 10026, 10027, 10029, 10030, 10031, 10032, 10033, 10034, 10035, 10036, 10038, 10039, 10040, 10041, 10044, 10047, 10048, 10128 Various Counties
 Adebunmi (Bunmi) Browne

✉ Email Address

Various ZIP Codes Providers: Balance Medical IPA
 Osaruyi Eduwen

✉ Email Address

Queens County ZIP Codes: 11101, 11102, 11103, 11104, 11105, 11106, 11368, 11369, 11370, 11371, 11372, 11373, 11374, 11375, 11377, 11378, 11379, 11385 Queens County
 Rui Kang (Ray) Lin

✉ Email Address

Queens County ZIP Codes: 111354, 11355
Queens County
Providers: CAIPA & Excelsior Empire Health Queens Provider
 Rosemond Guillaume

✉ Email Address

ZIP Codes: 11365, 11366, 11367, 11411, 11412, 11413, 11414, 11415, 11421, 11422, 11430, 11433, 11434, 11435; 11416, 11417, 11419, 11420, 11423, 11426, 11427, 11428, 11429, 11432, 11418, 11436, 11691, 11692, 11693, 11694, 11697
Various Counties

 Taylor Panzarella
✉ Email Address


Rockland and Westchester Counties: 10977, 10952, 10956, 10901, 10954, 10965, 10980, 10970, 10960, 10989, 10927, 10994, 10923, 10920, 10962, 10983, 10913, 10993, 10974, 10984, 10986, 10968, 10964, 10976, 10931, 10911, 10982, 10701, 10801, 10573, 10705, 10583, 10550, 10704, 10562, 10598, 10710, 10558, 10566, 10557, 10708, 10552, 10703, 10567, 10605, 10543, 10591, 10603, 10805, 10549, 10580, 10804, 10538, 10606, 10528, 10514, 10530, 10803, 10604, 10553, 10570, 10536, 10601, 10520, 10707, 10522, 10523, 10595, 10510, 10709 Rockland and Westchester County

 Haneefah Mahdi

✉ Email Address

Richmond County ZIP Codes: 10301, 10302, 10303, 10304, 10305, 10304, 
10305, 10306, 10307, 10308, 10309, 10310, 10311, 10312, 10313, 10314
Richmond County

Providers: Amboy Medical Practice, Bon Secours, NYC  Health & Hospitals, Refuah Health Center
 Leidy Mejia

✉ Email Address

Nassau County ZIP Codes: 11096, 11509, 11510, 11516, 11518, 11520, 11550, 11552, 11553, 11554, 11555, 11557, 11558, 11559, 11563, 11565, 11566, 11570, 11572, 11575, 11580, 11581, 11598, 11709, 11710, 11756, 11758, 11762, 11783, 11793,11001, 11020, 11021, 11023, 11024, 11030, 11040, 11042, 11050, 11501, 11507, 11514, 11530, 11542, 11545, 11548, 11560, 11568, 11576, 11577, 11579, 11590, 11596, 11714, 11732, 11735, 11753, 11771, 11791, 11797, 11801 Nassau County
 Robert Dean

✉ Email Address

Suffolk County ZIP Codes: 11720, 11721,  11724, 11725,11729;11731, 11733, 11738, 11740, 11741, 11742, 11743, 11746, 11747, 11754, 11757, 11763, 11764, 11766, 11768, 11769, 11776, 11777, 11778, 11780, 11782, 11784, 11786, 11787, 11788, 11790, 11794, 11901, 11930, 11931, 11933, 11934, 11935, 11937, 11939, 11940, 11941, 11942, 11944, 11946, 11948, 11949, 11950, 11951, 11952, 11953, 11954, 11701, 11702, 11703, 11704, 11705, 11706, 11707, 11708, 11709, 11713, 11715, 11716, 11717, 11718, 11722, 11727, 11750, 11751, 11752, 11755, 11767, 11772, 11779, 11789, 11792, 11795, 11796, 11798, 11955, 11957, 11958, 11959, 11961, 11962, 11963, 11964, 11965, 11967, 11968, 11970, 11971, 11975, 11976, 11977, 11978, 11980 Suffolk County
 Kay Stewart-Benjamin

✉ Email Address

Kings County: 11238, 11212, 11234, 11236 Kings County

Providers: NYU and Affiliates,  NYPHS and Affiliates, Mount Sinai and Affiliates
 Nadia Oleniak

✉ Email Address

ZIP Codes: 02886, 06484, 06518, 07020, 10002, 10003, 10006, 10007, 10010, 10013, 10016, 10017, 10019, 10027, 10023, 10025, 10029, 10032, 10034, 10036, 10037, 10075, 0301, 10304, 10305, 10312, 10451, 10452, 10455, 10457, 10458, 10459, 10461, 10462, 10463, 10464, 10466, 10469, 10508, 10523, 10604, 10952, 11042, 11102,  11103, 11104, 11203, 11204, 11206, 11207, 11208, 11209, 11210, 11212, 11213, 11214, 11215, 11216, 11218, 11219, 11220, 11223, 11224, 11226, 11228, 11229, 11230, 11234, 11235, 11236, 11237, 11238,  11354, 11355, 11358, 11360, 11361, 11362, 11364, 11365, 11368, 11372, 11373, 11374, 11375, 11377, 11385, 11411, 11416, 11418, 11419, 11423, 11427, 11432, 11435, 11436, 11691, 11772, 11940 Various Counties
 Steven Lee

✉ Email Address

ZIP Codes: 10002, 10013, 10314

Counties: Manhattan, Richmond

Providers: Charles B. Wang Community Health Center, CAIPA Manhattan Providers, Excelsior Empire Health Manhattan Providers, CAIPA Staten Island Providers


Upstate Regions:

Name Coverage Area
Assigned Providers
 Jane Sanderson

✉ Email Address

Counties: Dutchess, Saratoga, Schenectady, Washington Albany County Providers: Whitney Young, Northern Medical Group


 Barbara Bentley-Morrill

✉ Email Address

Counties: Albany, Clinton, Columbia, Essex, Green, Warren, All Vermont Providers: All Vermont Providers, Saratoga Hospital, Saratoga Regional Medical, Twin Rivers Medical

 Jaime Laube

✉ Email Address

Counties: Orange, Putnam, Rensselaer, Sullivan, Ulster

Providers: Hudson Valley Regional Community Health. Montefiore Medical Center, Union Community Health Center
 Penny Patterelli

✉ Email Address

Counties: Oneida, Onondaga, Otsego, Schoharie IPA: Trinity Health
Providers: St. Peters' Health Partners Medical Associates, Samaritan Hospital of Troy, St. Peter's Hospital, St. Joseph's Hospital Health Center, St. Joseph Medical PC.  Other: Family Care Medical Group, Crouse Medical Practice,  Family Care Medical Group, Mary Imogene Bassett, Little Falls Hospital, Mohawk Valley Health System, Rome Health
 Nicole Heldson
✉ Email Address
Counties: Genesee, Livingston, Niagara, Ontario, Orleans, Wyoming IPA: GLIN

Providers: Bertrand Chaffee Hospital, Bradford Regional Medical Associates (Upper Allegany Health System), ECMC, General Physicians,  Kaleida Health , Niagara Falls Memorial Medical Center, Olean General Hospital, UB Family Medicine INC dba UBMD Primary Care, Wyoming Community Hospital, Paul DeJac, Christopher Beney , Amandeep Pal, Oak Orchard Health, Anthony Jordan, FLH, Geneva Hospital, Finger Lakes Health Center
 Sarah Freyer

✉ Email Address

Counties: Franklin, Fulton, Hamilton, Herkimer, Montgomery, Saint Lawrence Providers: St. Regis Mohawk Tribe, Benardot Tribe, Nathan Littauer Hospital, North County Family, Carondelet, St. Mary's
 Maureen Hudson

✉ Email Address

Erie County  IPA: CIPA (Catholic Medical Partners) 

Catholic Medical Partners (CMP) Sisters Of Charity Hospital, Mount St. Mary's Hospital , Trinity Medical of WNY, PC., WNY Medical PC, Primary Care of WNY, Summit Pediatrics, Lockport Pediatrics, Frank Laurri, M.D. & Associates, Southgate Medical Group                             
 Christine Santiago
✉ Email Address
Counties: Allegany, Cattaraugus, Chautauqua, Chemung, Steuben, Yates IPA: Primary Care IPA

Providers: Family Health Medical Services, PLLC, Highgate Medical Group, PC., Northeast Medical, PC, Kenmore Family Medicine, Wheatfield Pediatrics, Delaware Pediatrics, Buffalo Pediatrics Other: Jones Memorial Hospital , Jones Memorial Services (U of R) Jamestown Pediatric , Southern Tier Pediatrics, Great Lakes Physicians Practice, PC, Community Inclusion Inc, Keuka Family Practice, Wayland Family & Sports Med, Gurdeep Kundlas, MD, Arnot Health UPMC of Chautauqua, Soldiers & Sailors
 Christine Jendraszek

✉ Email Address

Various Counties
IPA: CINQ Upstate and Downstate

Providers:  AEHS, INC.,Care Medical Practice, Community Health Center of Buffalo, Jericho Road Ministries, Medical Health Associates for Western NY, INC.  Southertier Community Health Center Networks, INC., The Chautauqua Center, INC, Tri-County Family Medicine Program, INC., Lakeshore Family Medicine Associates, Liberty Resources, Ted J. Triana, Urban Family Practice, Westfield Family Physicians, John Mulawka-dba Southtowns Pediatrics, Lynne Ross dba Canalside Primary Care, Mobile Physicians Services PLLC, Robert Ericson Do &Jennifer Ericson Do dba Inspired Health Group
 Robert Chantra

✉ Email Address

Counties: Monroe, Wayne IPA: GRIPA, Guthrie

Providers: Rochester Regional Health System- (RRHS) Rochester General Hospital, The Unity Hospital of Rochester United Memorial Medical Center, Western New York Medical Practice, Clifton Springs Hospital & Clinic, Newark Wayne Community Hospital (St. Lawrence Health Systems) Massena Hospital, Canton Potsdam Hospital & Medical Practice, Gouverneur Hospital Guthrie Health-Guthrie Corning Hospital, Guthrie Cortland Medical Center, Guthrie Robert Packer Hospital, Guthrie Troy Hospital University of Rochester (U of R) Strong Memorial Hospital         
 Nicole Lloyd

✉ Email Address

Counties: Cayuga, Jefferson IPA: Main Street Rural

Providers: Auburn Community Hospital, all of Cayuga County and Jefferson County
 Karen Yonkers-Santy

✉ Email Address

Counties: Cortland, Oswego, Schuyler, Seneca, Tioga, Tompkins IPA: Cayuga Health Partners, FLIPA, NYSMG

Providers: FLIPA- Family Health Network of CNY, Northern Oswego County Health Services Inc., Upstate Family Health Center, Inc. Other: Cayuga Medical Associates, Oswego County OB-GYN, New York Senior Medical Group
 Peter Stone

✉ Email Address

Counties: Broome, Chenango, Delaware, Lewis, Madison IPA: Concordia                                                                                       
Providers: United Health Services (UHS) Chenango Memorial Hospital INC, Delaware Valley Hospital INC, United Health Services Hospitals, INC, United Medical Associates. Concordia- Oneida Medical Practice PC, Oneida Health Systems INC, Oneida Medical Associates PLLC. Other: Endwell Family Physicians, Lewis County General Hospital

Provider Quality News


Fidelis Care Begins Member Education Campaign as Federal Continuous Coverage Requirement Comes to an End
4/6/2023 • Posted by Fidelis Care in Corporate News, Member News

LONG ISLAND CITY, NY [April 6, 2023] – Fidelis Care announced today it will begin an extensive educational outreach and awareness campaign to more than 2 million members across all 62 counties in New York State who will need to update their eligibility information to renew their health coverage for the first time in three years.

Based on the Consolidated Appropriations Act, 2023, signed into law by President Biden on December 29, 2022, the “continuous enrollment condition” for Medicaid, Child Health Plus, Essential Plan and Managed Long Term Care coverage that began in March 2020 during the onset of the COVID-19 public health emergency (PHE) will soon end. 

Most New York State residents who have coverage through these plans will need to update their eligibility information as part of the renewal process over the next 12 months, depending on their coverage end dates. The first renewal reminders were sent in March to individuals whose coverage ends June 30, 2023.

The return to an annual renewal process is a major change from the past three years, when coverage was extended automatically with no action needed by the member. For hundreds of thousands of members who enrolled with Fidelis Care during the PHE, as well as for millions of New Yorkers enrolled in Medicaid, renewing their health insurance each year will be a new experience. Over the next 12 months, Fidelis Care will work to help approximately 2 million members renew their coverage.

“Fidelis Care wants to ensure members continue to have access to the care and services they need,” said Megan Woodward, Vice President, Member Retention. “As we begin this process, we are highlighting how important it is for members to pay close attention to all communications they receive so they can renew on time and keep their coverage without interruption. Now is the best time for members to ensure their contact information is up to date so they receive the information they need.”

Fidelis Care, which has the largest Medicaid, Child Health Plus, and Essential Plan membership among health plans in New York State, has been preparing for several months to assist members with the renewal process. The health plan will deploy a comprehensive outreach effort – from social media to provider education to community events – to assist members in completing their renewal application.

There are several ways for members to get help or ask questions about the upcoming renewal process. Fidelis Care’s highly trained and knowledgeable representatives speak multiple languages and are available to provide 1:1 assistance. Fidelis Care’s Member Retention team can be reached at 1-866-435-9521, Monday through Friday, 8:30 a.m. to 6 p.m.

One-to-one assistance is also available at Fidelis Care’s 24 community offices across New York State, and by visiting the plan’s fleet of more than 75 “Streetside” RV locations. For more information about locations and hours, members can visit fideliscare.org/offices. Special information is also available for members at fideliscare.org/renew.  

Members who enrolled in their insurance with NY State of Health (NYSOH), will also be able to renew by calling NYSOH at 1-855-355-5777; TTY: 1-800-662-1220, Monday through Friday from 8 a.m. to 8 p.m. or Saturday from 9 a.m. to 1 p.m. Or, they can visit www.nystateofhealth.ny.gov 24 hours a day, 7 days a week and log in to their account.

Members who are enrolled through their local department of social services or through the Human Resources Administration (HRA) in New York City will receive a renewal packet in the mail and will need to complete their paperwork thoroughly within the requested timeframe.

"Fidelis Care is committed to providing our members with the information they need to maintain their eligibility for coverage,” added Woodward, who emphasized that members need to take action to retain their health insurance coverage as their renewal date approaches. “We are here to help every step of the way.”

 



About Fidelis Care:
Fidelis Care is a mission-driven health plan offering quality, affordable coverage for children and adults of all ages and at all stages of life. With more than 2.5 million members statewide, Fidelis Care believes that all New Yorkers should have access to affordable, quality health in-surance. Follow us on LinkedIn at linked.com/fideliscare, on Twitter at @fideliscare, Instagram at @fideliscare, and on Facebook at facebook.com/fideliscare. For more information, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547) or visit fideliscare.org.

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 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.

Provider Tip Sheets - Quality

Quality

Adult Wellness Visit Tip Sheet

Behavioral Health Case Management Services Tip Sheet

Behavioral Health Follow-Up Measures

Breast Cancer Screening Tip Sheet

Child and Adolescent Well Care Visits Tip Sheet

Childhood Immunization Status Tip Sheet

Closing the Gap on Follow-Up Care After Discharge

Colorectal Cancer Screening Tip Sheet

Continuity of Care Tip Sheet

Controlling High Blood Pressure Tip Sheet

Depression Screening and Follow-Up for Adolescents and Adults

Flu Shot for Adults Tip Sheet

Follow-up Care for Children Prescribed ADHD Medication (ADD) Tip Sheet

Glycemic Status Assessment for Patients with Diabetes (GSD) Tip Sheet

HEDIS® Tip Sheet 2021 Antidepressant Medication Management (AMM)

HEDIS® Immunizations for Adolescents Combination 2 (IMA-2)

Importance of Chlamydia Screening Tip Sheet

Importance of Follow-Up Care for Mental Illness

Improving Cardiometabolic Health for Members with Diabetes Tip Sheet

Kidney Health Evaluation for Patients with Diabetes (KED) Tip Sheet

Low Back Pain Tip Sheet

Metabolic Monitoring for Children and Adolescents on Antipsychotics Tip Sheet

Patient Satisfaction Surveys Tip Sheet

Postpartum Depression Screening and Follow-up Tip Sheet

Preventive Cancer Screenings and Vaccines Tip Sheet

Primary Care Provider (PCP) Quality Tip Sheet

Psychiatric Collaborative Care Model

Smoking Cessation Provider Tip Sheet

Telehealth Guide for Health Home Care Managers

Telehealth Tip Sheet

Transitions of Care (TRC) Tip Sheet

Viral Load Suppression Tip Sheet

Well Child - Birth to 30 Months Well Care Visits Tip Sheet

Wellcare Partnership for Quality Program - 2026

Quality Policies

 

Latest Provider Bulletin

 


Provider Bulletin Archives ➔


Fidelis-Care-Summer-Health-Newsletter