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LATEST NEWS


Children and Family Treatment and Support Services (CFTSS) Utilization Review Process Effective July 1, 2025
5/30/2025 • Posted by Provider Relations
Fidelis Care would like to notify our providers of an update to our Children and Family Treatment and Support Services (CFTSS) Utilization Review Process.
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Fidelis Care Authorization Grids Effective July 1, 2025
5/29/2025 • Posted by Provider Relations
The following section of the Fidelis Care authorization grids have been updated effective July 1, 2025.
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Annual Medicare Special Needs Program (SNP) Model of Care (MOC) Provider Training
5/19/2025 • Posted by Provider Relations
The Centers for Medicare and Medicaid Services (CMS) requires that providers receive Medicare Special Needs Program (SNP) Model of Care (MOC) Training annually.
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Invitation to Fidelis Care’s June Provider Office Hours
5/16/2025 • Posted by Provider Relations
Fidelis Care will host three Provider Office Hours in June 2025. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.
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Updated Evolent Authorization Requirements Effective June 1, 2025
5/16/2025 • Posted by Provider Relations
The following codes on the Evolent/Fidelis Care authorization grid have been updated effective June 1, 2025.
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Measure Coding Education – Kidney Health Evaluation for Patients with Diabetes (KED) 82043 vs. 82044
5/14/2025 • Posted by Provider Relations
Diabetes is the leading cause of chronic kidney disease affecting almost one in three people. Clinical guidelines recommend that all people with diabetes have routine tests to detect kidney disease. However, less than half get the needed tests. 
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Provider Access Online

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Social Care Network

Starting January 1, 2025, members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans will have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Required Cultural Competency Training

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Utilization Management (UM)

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