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Do you need assistance? Please visit our Contact Provider Relations page to find your designated Provider Relations Specialist.
Access to quality care is essential to reducing health disparities and improving the quality and length of life for all New Yorkers.
The New York State Department of Health (NYSDOH) and CMS require that specific Access and Availability Standards be met by Primary Care Providers (PCPs), OB/GYNs, Specialists, and Behavioral Health Providers.
To ensure compliance, Fidelis Care conducts regular Access & Availability surveys to confirm providers meet these state-mandated standards for all Fidelis Care members.
The survey evaluates:
Common issues leading to non-compliance include:
To remain in compliance providers must:
To help your office prepare for upcoming surveys, we’ve created two new tip sheets:
If you have questions or need assistance, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, visit: Contact Your Designated Provider Relations Specialist.
Assisting providers in staying abreast of the latest trends, policies, and studies.
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To submit prior authorization request types, use the Fidelis Care provider portal.
Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.
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