El blog de Fidelis Care

Fidelis Care’s Pharmacy Services would like to provide clarification on how medications are covered under member’s medical and pharmacy benefits.   Medications Covered Under Fidelis Care Medical Benefit Physician Administered Drugs – medications administered to a member during an outpatient visit Providers obtain medication via “buy-and-bill” or shipment to their practice site from a vendor of their choosing. Coverage is dictated by Fidelis Care Authorization Grids, Prior Authorization Lookup Tool and/or Evolent Specialty Services (formerly NCH) Authorization Grids (Oncology Regimen Specific). Medical Benefit Authorization Grids are plan specific. If a medication is listed on one of the above authorization grids/tools, an authorization

Timely follow-up care after a mental health discharge is a vital component of recovery. Clinical guidelines recommend that individuals discharged from an emergency department (ED) or inpatient setting receive a follow-up visit within seven (7) days. This window is crucial for maintaining continuity of care, reducing the risk of readmission, and supporting long-term wellness. To help meet this need, Fidelis Care has partnered with Brave Health, a virtual behavioral health provider offering accessible services such as therapy, psychiatry, and care coordination. Brave Health’s telehealth model allows members to receive care from the comfort of their homes, making it easier to stay

El trastorno por consumo de sustancias (SUD, por sus siglas en inglés) afecta a muchas personas. Puede suceder en cualquier familia, lugar de trabajo o vecindario. En Fidelis Care, creemos que la adicción al alcohol o las drogas no es un fracaso personal. También sabemos que las personas necesitan ayuda, y no ser juzgadas.

Fidelis Care will host three Provider Office Hours in October 2025. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – October 2025   Topic: Fidelis Care Tools & Resources Overview When:  Thursday, October 9th – 12PM – 1PM EST Click here to register*   Topic: Fidelis Care and Wellcare - Quality Programs When:  Wednesday, October 15th – 10 AM – 11 AM EST

Octubre es el Mes de la Alfabetización en Salud. Es un buen momento para aprender a comprender y utilizar la información de salud. La alfabetización en salud significa que usted tiene la capacidad de encontrar, comprender y utilizar información para tomar buenas decisiones sobre su salud. Esto puede ayudarlo a: • Leer las etiquetas de los medicamentos. • Elegir un plan de salud. • Hacer preguntas a su médico.