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12/18/2018 • Posted by Provider Relations
Fidelis Care is working to support the HEDIS Measure for Use of Imaging Studies for Low Back Pain (LBP).  As defined by HEDIS, use of imaging studies for low back pain includes the percentage of members 18-50 years of age who had a primary diagnosis of low back pain and did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of diagnosis. 
12/10/2018 • Posted by Provider Relations
Annually, Fidelis Care is required by the Centers for Medicare and Medicaid Services (CMS) to submit complete diagnostic data for Qualified Health Plan members. To help us obtain the necessary medical records for submission, Fidelis Care is working in partnership with Optum and CiOX Health*.
12/6/2018 • Posted by Provider Relations
On January 1, 2019, the Medicare Preferred Drugs list will change. To ease the transition, impacted members and providers have been notified of the upcoming changes.
11/30/2018 • Posted by Provider Relations
As a Medicare/Medicare-Medicaid provider, you know that quality health care is a high priority for Fidelis Care and the Centers for Medicare & Medicaid Services (CMS). CMS considers statin use an important quality measure in patients with diabetes.
11/30/2018 • Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2018 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 10/15/2018.
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Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on numerous health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

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