Provider Education

Chronic Care Improvement Program (CCIP) and Quality Improvement Program (QIP) Information: Heart Failure Education

Information and links to resources for the Chronic Care Improvement Program and Quality Improvement Program, targeting heart failure in cooperation with CMS.

Chronic Disease Management Programs
Fidelis Care is committed to supporting members with chronic diseases through programs that help them better manage their health through a combination of education and care planning. 

Once diagnosed, members can access our disease management programs in two ways: written information that is mailed to their home, or one-on-one phone outreach from a Nurse Care Manager. 

We provide important educational information in our newsletters and on our website, fideliscare.org, as well as through customized letters, brochures, and other materials that are sent to members.
Learn more about Fidelis Care's Chronic Disease Management Programs.

Clinical Practice Guidelines
Clinical Practice Guidelines have been developed to aid the practitioner in clinical decision-making for specific circumstances.

Clinical Preventative Services Guidelines (.pdf)
Clinical preventive services guidelines for all ages.

Domestic Violence Intervention: A Guide for Health Care Professionals
Many factors about an individual’s life circumstances may influence their ability to seek help and reap the most positive benefits from the help that is offered. The following information may provide some guidance in dealing with the diversity of the patients you may encounter.

(Clicking this link will cause you to leave the Fidelis Care website)

Early Childhood Oral Health (.pdf)
What You Need to Know About Fluoride Varnish and How You Can Promote Early Childhood Oral Health.

HealthierLife (HARP) Performance Improvement Project (PIP)
2017-2018 HealthierLife (Health and Recovery Plan - HARP) Performance Improvement Project (PIP):
Improving HARP Behavioral Health Inpatient Care Transitions Back into the Community. 

For the next 2 years (2017-2018), Fidelis Care is required by the New York State Department of Health (SDOH) to engage in a HARP Performance Improvement Project around HealthierLife (HARP) member care transitions following an inpatient behavioral health episode. Fidelis Care is using this opportunity to collaborate with all of our providers to improve our members' behavioral health experiences. The goals of this project are to: identify and improve discharge processes; ensure warm hand-offs; improve the facilitation of communication and coordination among the inpatient providers; increase frequency of contact with members, community providers, and member stakeholders; and increase focus on the post-discharge follow-up. 

To learn more about the Fidelis Care HARP PIP, contact Kevin Jerry, Project Manager, at (718) 393-6566 or visit the link above. 

Links to non-profit health organizations' Web sites

Maternal Child Health
Links for information on Maternal and Child Health

Meningococcal Vaccine Update

Project TEACH
Supporting primary care physicians in diagnosing and treating children with mental health disorders.

Provider's Guide to Public Health (.pdf)
Fidelis Care's Provider's Guide to Public Health

Special Needs Plan (SNP) Model of Care
A guide to providing quality care to those who have chronic medical conditions

Links for confidential STD services
Confidential STD services are available at DOHMH facilities for non-enrolled sexual and needle-sharing partners at no charge.

STD Treatment Guidelines

Links for substance abuse information and assessment

HIV Treatment Guidelines
Providers seeking to provide care to members with HIV will find important information on HIV treatment (for adults, adolescents, pediatrics, perinatal care,

post-exposure prophylaxis [occupational and non-occupational]), HIV Prevention and HIV Testing at the following websites:

http://www.aidsinfo.nih.gov/guidelines
http://www.hivguidelines.org/

Providers seeking to find out more about available clinical trials for members with HIV will find important information at the following website:
http://www.aidsinfo.nih.gov/clinical-trials


Observation Services

The Centers for Medicare and Medicaid Services (CMS) and New York State Medicaid, including Medicaid fee-for-service (FFS) and Medicaid Managed Care plans, recognizes observation care as a well-defined set of clinically appropriate services that include ongoing short term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further treatment as hospital inpatients, or if they are able to be discharged from the hospital. Recently NYS Medicaid expanded coverage of observation services. The following guidance was provided in the New York State Medicaid Update – May 2013 Volume 29 – Number 5. More Information About Observation Services


Smoking Cessation Benefits and Counseling

As you know, smoking and the use of tobacco products is one of the greatest public health challenges we face. The New York State Department of Health has challenged Fidelis Care and other health plans in the State with increasing the identification of smokers and increasing the quit rates over the next two years. To help this cause, a variety of smoking cessation products and services are available to members who want to quit. These products and services include: smoking cessation counseling, prescription and non-prescription smoking cessation products such as nasal sprays, inhalers, Zyban (bupropion), Chantix (varenicline), over-the-counter nicotine patches, and gum. Learn more about the smoking cessation benefits Fidelis Care has to offer.  

UPDATE: Fully Integrated Duals Advantage (FIDA) Provider Training

Providers participating in the FIDA Demonstration are required to complete provider training on a number of key subjects. Earlier this year, participating FIDA providers were informed of the availability of the first FIDA training, FIDA Overview Training. Starting this week, four additional training modules are now available at https://fida.resourcesforintegratedcare.com. The training offers education on FIDA and also addresses the special needs of this vulnerable population, with the goal of ensuring the delivery of quality care to FIDA participants. The additional courses are as follows:

  • Behavioral Health
  • Cultural Competency
  • Disability Awareness
  • Recovery and Wellness

The training courses are also available in a downloadable format. For information and directions on how to complete the downloadable training, please visit https://www.resourcesforintegratedcare.com/FIDA_Downloadable_Provider_Training

Fluoride Varnish Applied by Physicians and Nurse Practitioners
Fidelis Care is now accepting the application of fluoride varnish (D1206) to be administered by certified physicians or nurse practitioners. Prior to providing fluoride varnish treatments, practitioners must complete a web-based or in-person training in order to receive payment for claims. Providers that are not certified should visit the New York State Department of Health website for a list of training programs: https://www.health.ny.gov/prevention/dental/child_oral_health_fluoride_varnish_for_hcp.htm.

Get more information on additional requirements, claims processing and reimbursement.

Important update on HIV treatments