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IMPORTANT: 2022MY QARR/HEDIS Medical Record Review - Second Requests are Now Available!
3/15/2023 • Posted by Provider Relations

Fidelis Care is pleased to inform you that the medical record request letter and details for 2022 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible. Thank you in advance for your cooperation on this important matter. Should you have any questions or concerns, please do not hesitate to contact Fidelis Care’s Provider Call Center at 1-888-FIDELIS (1-888-343-3547) or your local Provider Partnership Associate.

As part of the New York State Quality Assurance Reporting Requirements (QARR), National Committee for Quality Assurance (NCQA), and HEDIS reporting requirements for the Centers for Medicare and Medicaid Services (CMS), Fidelis Care and WellCare by Fidelis Care annually reviews charts of selected members to assess the quality of clinical care. Since Fidelis Care is a covered entity under HIPAA, a special authorization is NOT needed to process this request.

Please help us meet NCQA deadlines by submitting all requested information by 4/14/2023

 

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Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

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.

Join Our Network

Apply to our network and become a part of the Fidelis Care mission. 

Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Electronic Transactions

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Utilization Management (UM)

Find information and links to external vendor authorizations and to internal resources.