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6/16/2020 • Posted by Provider Relations
As a reminder, effective June 1, 2020, WellCare of New York, Inc. Medicaid, Child Health Plus, Essential Plan, Health and Recovery Plan (HARP), and Managed Long Term Care members will transfer to Fidelis Care.  WellCare Medicare members are not affected by this change.   This announcement is to help providers with changes affecting current New York Medicaid members’ 2020 Claim Submissions, Member Eligibility, Claim Status Inquires, and Customer Service information.  We want to help your billing department process your claim submissions as efficiently as possible. Please use the date of service guidance on the Provider page of our website to send a claim submission to the correct payer to avoid an eligibility rejection.
6/16/2020 • Posted by Provider Relations
Fidelis Care is pleased to announce the new Quality Care Incentives (QCI) Brochure is now available on Provider Access Online.
6/15/2020 • Posted by Provider Relations
Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community.
6/10/2020 • Posted by Provider Relations
Fidelis Care, as a Medicaid Managed Care plan, is required by Federal and State regulations to monitor and ensure the quality of services offered by contracted network providers for behavioral health (BH - mental health and substance use disorder) services. Also, Fidelis Care must offer training to providers in clinical core competencies and evidence-based practices.
6/10/2020 • Posted by Provider Relations
The New York State Department of Financial Services (DFS) posted a coronavirus (COVID-19) regulation update regarding mental health services coverage for Medicaid Managed Care Plans and Essential Plans, effective 5/2/2020.
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Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

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