Update: Submission of Special Supplemental Benefits for the Chronically Ill Effective January 1, 2023
1/9/2023
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Posted by Provider Relations
Fidelis Care partners with providers to develop and deliver high-quality, cost-effective health care solutions. We understand that maintaining a healthy community starts with providing care to those who need it most. Special Supplemental Benefits for Chronically Ill (SSBCI) are offered to Fidelis Care’s highest-risk members who meet specific criteria for eligibility based on the Centers for Medicare and Medicaid Services (CMS) guidelines.
Effective January 1, 2023, you can check eligibility requirements and submit attestations on behalf of members online at ssbci.rrd.com; fax attestations will no longer be accepted.
Steps to determine eligibility, submit attestations and activate benefits:
Members are required to schedule an office visit with their physician or participating physician group for evaluation. Once appointment is made, please follow the steps below:
1. Visit ssbci.rrd.com.
2. Follow the steps on ssbci.rrd.com to evaluate your patient against the eligibility requirements outlined on ssbci.rrd.com.
3. Submit an attestation form through ssbci.rrd.com indicating your patient meets the eligibility requirements.
4. Submit a claim containing the appropriate ICD-10 codes from this office visit indicating a member has been diagnosed with one or more qualifying chronic conditions listed on ssbci.rrd.com.
5. Upon receipt of all required information, the member will be sent an approval or denial letter within 10 business days. Approval letters include information on steps the member should follow to activate supplemental member benefits.
If you have questions regarding attestation requirements, please contact your local Provider Relations Specialist or call 1-888-FIDELIS (1-888-343-3547).