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Fidelis Care has partnered with Ophelia to provide free, fully virtual opioid use disorder treatment for all Fidelis Care, Ambetter from Fidelis Care, and Wellcare by Fidelis Care members. Ophelia is available in every county in New York State. Ophelia is a treatment provider available at no additional cost to members with opioid use disorder. Their mission is to make high-quality, evidence-based Medications for Opioid Use Disorder (MOUD) care affordable and accessible to all.  Ophelia’s services include: Easy referral process, available 7 days a week Judgment-free care specialized in opioid use disorder treatment 100% remote, no transportation needed Care is fully covered

Fidelis Care will host two Provider Office Hours in December 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions. Provider Office Hours – December 2024   Topic: Pharmacy Overview When:  Thursday, December 5th – 2PM – 3PM EST Click here to register*   Topic: Fidelis Care and Wellcare Quality Programs When:  Tuesday, December 10th – 1PM – 2PM EST Click here to register*  

Beginning Nov. 18, you can validate eligibility and benefits, submit claims, check claim status, submit authorizations, and access Fidelis Care payer resources via Availity Essentials. Availity experts are hosting several live webinar sessions to help you get ready. Here’s a look ahead at what tools and functionality are coming, paired with live training to learn more. Space is limited, save your seat today!   Availity Essentials Introduction Monday, Nov. 18 – 3 p.m. EST Monday, Dec. 2 – 2 p.m. EST Authorization Tools Tuesday, Nov. 19 – 2 p.m. EST Tuesday, Dec. 3

As you may know, the United States is experiencing an IV fluid shortage after Hurricane Helene.  Fidelis Care would like to provide guidance regarding prior authorization (PA) requests that may be affected by this shortage.   Medications for use in Non-Oncology Diagnoses (PA Requests Submitted Directly to Fidelis Care Pharmacy) Fidelis Care is aware of the IV Fluid supply chain issues and has processes in place to consider the impacts of the IV Fluid shortages when reviewing medication Prior Authorization (PA) requests, for as long as the shortage is in effect. Providers must include communication and/or documentation that the medication Prior Authorization

Fidelis Care would like to inform our providers of plan changes that will be effective January 1, 2025.      Wellcare By Fidelis Care   Wellcare Fidelis Dual Plus (HMO D-SNP) - Plan 008 Effective January 1, 2025, Fidelis Care members currently in this plan will be enrolled in Wellcare Fidelis Dual Plus (HMO D-SNP) – Plan 003, unless the member chooses another plan.  

Effective January 1, 2025, Social Adult Day Care (SADC) transportation will remain a covered benefit under MLTC Plans and SADCs will no longer have the option of their transportation being carved out to fee-for-service. All SADCs will be responsible for managing their own transportation. SADC Programs can opt to use their own vehicles or contract directly with transportation vendors to secure transportation of SADC members to SADC programs. Before January 1, 2025, SADCs must transition any members whose trips to and from the SADC are arranged through their contracted MLTCP, MAP plan or through MAS to having their trips arranged and