El blog de Fidelis Care

  Si usted o un ser querido tiene dolor en el pecho, puede darle miedo ir a la sala de emergencias. Saber cómo será puede darle tranquilidad. Cuando llegue, los médicos y el profesional de enfermería trabajarán rápido para controlarle el corazón. 1. Control rápido al llegar Un profesional de enfermería le preguntará cómo se siente y cuánto le duele. Si el dolor parece grave, lo controlarán de inmediato. Quizás le coloquen un monitor para controlar su ritmo cardíaco y oxígeno.   2. Estudio del corazón (ECG) Es muy probable que le hagan un estudio del corazón en 10 minutos. El estudio se llama electrocardiograma (ECG). Qué

History is made of fine details that form a much larger picture. These intricate lines and strokes shape who we are. February commemorates the rich Black history that has allowed me to stand in my achievements today. This month reminds me of my mission: to pour into my community. I cannot simply tell you how I observe this month, because in many ways, I am it. I am the product of hundreds of years of sacrifice, trust, resilience, and community that Black Americans have embodied. In recognizing these sacrifices, I want to share how this month directly aligns with the work

Fidelis Care would like to remind our provider community of the required protocols for submitting corrected claims and to clarify how these differ from appeals. Following these guidelines helps ensure timely and accurate claims processing.   What Is a Corrected Claim? A corrected claim is used when the provider needs to modify or replace a previously submitted claim due to an error—such as coding, billing, or demographic inaccuracies. Examples include: Incorrect procedure code Wrong units of service Member demographic correction Billing error requiring claim replacement Corrected claims must follow the format requirements above and be submitted within 60 calendar days from the date of the

Fidelis Care is committed to strengthening our partnership with providers and enhancing the overall experience when addressing claims‑related concerns. As part of this ongoing effort, we are introducing a new Fidelis Care Claims Inquiry Template, which will be required beginning March 1, 2026 for all claims inquiries submitted after the standard appeals process has been completed.   This updated process was designed to support a smoother, more transparent experience for your practice — with several key benefits: Improved Service and Support The new claims grid template allows us to collect all essential information at the start of your inquiry. With complete information in hand,

New York CMS Cell Gene Therapy Access Model Update The New York State (NYS) Department of Health has applied to participate in the federal Centers for Medicare and Medicaid Services (CMS) Cell and Gene Therapy (CGT) Access model. The model is voluntary for State Medicaid programs and manufacturers and will test whether a CMS-led approach to developing outcomes-based agreements (OBAs) for cell and gene therapies increases Medicaid beneficiaries’ access to innovative treatment, improve health outcomes, and reduces health care costs to State Medicaid programs. The initial focus of the model is on gene therapies for people living with sickle cell disease,