Miembros
Proveedor
Adquiera un plan

¡Bienvenidos, proveedores!

 

ÚLTIMAS NOTICIAS


Monday • Posted by Provider Relations
The METS program is an integrated, whole health approach to support members with significant behavioral health challenges. It includes behavioral health, medical, therapeutic, pharmacy, and supplemental services. METS’ purpose is to focus on the recovery and resiliency of each person. The goal is to help members remain in their community. Members are internally identified using claims history over a 12-month period. If you have a patient identified for the program, a METS Clinical Liaison will reach out to you to discuss the member’s treatment plan and progress. The METS team partners with both the provider and the member to ensure the member achieves
Last Week • Posted by Provider Relations
Fidelis Care is pleased to inform you that the medical record request letter and details for 2023 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible. Thank you in advance for your cooperation on this important matter. Should you have any questions or concerns, please do not hesitate to contact Fidelis Care’s Provider Call Center at 1-888-FIDELIS (1-888-343-3547). As part of the New York State Quality Assurance Reporting Requirements (QARR), National Committee for Quality Assurance (NCQA), and HEDIS reporting requirements for the Centers
3/13/2024 • Posted by Provider Relations
As of January 1, 2024, Fidelis Care has partnered with MCG Health to implement the MCG Cite Guideline Transparency Tool. Providers can access this feature through the Fidelis Care Provider Portal. With the MCG Cite Guideline Transparency Tool, Fidelis Care shares clinical indications with providers. The tool is a secure resource that helps meet regulations around transparency for care delivery. Benefits include: Transparency: Delivers industry-leading medical determination transparency. Access: Allows the review of MCG clinical evidence used by payers to support         member care decisions. Security: Ensures easy and flexible access via secure web access. This Quick Reference Guide details how to
3/12/2024 • Posted by Provider Relations
Providers, please remember to review content available in Provider Access Online (Fidelis Care's secure Provider Portal) and the rest of this Provider section of the Fidelis Care website.  Both locations are excellent resources of information about our programs and services.  One example of a resource contained in this site is our Provider Manual.  The Provider Manual contains details about our credentialing processes and our member rights and responsibilities statement.  It also includes information about the clinical criteria used in utilization management (UM) decision-making, our pharmacy authorization processes, and Fidelis Care's policy statement on how coverage decisions are made.   Other items you will find in
3/11/2024 • Posted by Provider Relations
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.  
Older Articles


Acceso para proveedores

Verifique la elegibilidad de los miembros, consulte el estado de las reclamaciones y más.

Boletín Estado de Nueva York

Lea el Boletín para proveedores del estado de Nueva York más reciente y explore los archivos.