Miembros
Proveedor
Adquiera un plan

Bienvenidos, Corredores!

Fidelis Care atiende a más de 1,7 millones de niños y adultos de todas las edades, lo que nos convierte en uno de los planes de seguro médico más grandes del estado de Nueva York. Nos fundamos con la creencia de que todos los neoyorquinos deberían tener acceso a un seguro de salud asequible y de calidad, y nuestra misión de ayudar a los demás informa todo lo que hacemos. 

Últimas Noticias


Medicare Member Plan Benefits for Applicable COVID-19 Testing, Screening, and Treatment Services
8/15/2023 • Posted by Provider Relations in Provider News

Earlier this year, the Biden Administration announced that the federal Public Health Emergency (PHE) related to the COVID-19 pandemic ended on May 11, 2023.

During the PHE, we followed guidance from the Centers for Medicaid & Medicare Services (CMS) and instituted temporary waivers for select services. This action ensured that critical care could be quickly delivered to our members during a time of heightened need. Beginning May 12, 2023, these temporary waivers expired, and our members’ Medicare plan benefits are reinstated for the following services:

 

Service

Member Liability

Prior Auth Needed?

COVID-19 Testing and Screening

(Administered by Provider)

Per member plan benefits

No

COVID-19 Vaccinations

$0 member cost-share for

vaccine administration*

No

COVID-19 Monoclonal Antibody Treatments

$0 member cost-share for

treatment administration*

Prior authorization only required for CPT code Q0221

*Vaccine ingredient cost is still covered directly by Medicare FFS.

Alongside these waivers, the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided for a 20% increase to the inpatient prospective payment system (IPPS) Diagnosis Related Group (DRG) rate for COVID-19 patients for the duration of the public health emergency. This increase applied to claims that included the applicable COVID-19 ICD-10-CM diagnosis code and met the date of service requirement. When the PHE ended on May 11, 2023, these add-on payments are no longer included for discharge dates of service as of May 12, 2023 and thereafter.

Fidelis Care is committed to providing a smooth transition for both our members and providers as we resume business as usual. While we will continue to communicate any updates to our business practices directly to our provider partners, we always highly recommend that providers verify member eligibility, benefits, and prior authorization requirements before rendering services.

Broker Resources

Access forms, manuals, and other important documents and guides for Fidelis Care members. 

My Advocate

Help Fidelis Care members find and apply for money-saving programs. 

Transferencia Electrónica

Reciba cheques de comisiones a través de Transferencia Electrónica de Fondos.

Encuentre a un médico

Busque a un profesional, un servicio o un centro médicos en la red de Fidelis Care.

¡Visítenos!

¿Tiene preguntas sobre su cobertura médica? Encuentre una oficina comunitaria de Fidelis Care cerca de usted.