Annual cultural competency training for participating providers is required by the New York State Department of Health. At this time, The New York State DOH will only accept the approved training offered by the United States Department of Health and Human Services (HHS), Office of Minority Health education program, Think Cultural Health, to fulfill the requirement for provider annual cultural competency training.*
Once the cultural competency training has been completed, providers need to verify completion of the program by emailing the Cultural Competency Attestation Form to:
The required Cultural Competency Training needs to be completed annually by December 31st. Providers that completed
The Medicaid Drug Rebate Program (MDRP), established by the Omnibus Budget Reconciliation Act of 1990 (OBRA '90), requires that drug manufacturers to enter into an agreement with the Centers for Medicare and Medicaid Services (CMS) to provide rebates for drugs covered by Medicaid. Reimbursement for practitioner-administered drugs is only allowed if the drug qualifies for rebate in accordance with 42 USC 1396r-8.
Providers are encouraged to use the tools below to determine if a practitioner-administered drug will be reimbursable through Fidelis Care Medicaid and HARP plans. Claims submitted with NDC numbers that are not on the list of approved manufacturers will
Fidelis Care is has been made aware that Ambetter from Fidelis Care and Essential Plan members received ID cards with incorrect billing information located on the back of the ID card. Please do not use the Payor ID or the Claims address listed on the member ID card, unless the information below is present.
The correct information is as follows:
Ambetter from Fidelis Care –
Payor ID – 11315
Medical Claims Address – Fidelis Care, PO Box 724, Amherst, NY 14226-0724
Essential Plans –
Payor ID – 11315
Medical Claims Address –
Fidelis Care is pleased to inform you that the most recent 2023 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 12/12/2023. Please refer to the most recent "Non-Compliance Report" instruction letter to understand the information being provided on each tab of the Excel Spreadsheet. Please notify any staff involved with quality management and advise that these documents have been posted. If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
Providers are required to maintain up-to-date demographic information to ensure efficient and timely processing of claims, accurate provider directory information, and appropriate contact information for communication. As a reminder to our Fidelis Care providers, please review your demographic information in the Provider Portal on a regular basis to ensure the provider data is accurate.
If you have any questions regarding the Provider Portal, or would like to submit your demographic changes in another format (fax, email, or delegated roster), please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.