9/5/2023
• Posted by Provider Relations
As part of a year-end push to improve medication adherence, WellCare and WellCare By Fidelis Care are offering an additional financial incentive (Incentive Payment Program) to its providers who use RxEffect® to identify and take action in the following Star ratings medication therapy areas:
Diabetes
Blood Pressure
Cholesterol
Incentive Payment Program Criteria:
This Incentive Payment Program offers $100 per Qualifying Member Therapy (max of $150 per member depending on number of therapy areas) between August 11, 2023 through December 31, 2023. The Bonus is based on Eligible Members getting their last medication fill for end of year adherence, and is broken
9/1/2023
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2023.
The Medicaid, Medicare, Essential Plan and Metal-Level grids have been updated as follows:
E. OASAS Licensed Inpatient Substance Use Disorder Treatment:
The facility may fax or email the OASAS Appendix A Notification Form and OASAS LOCADTR Medical Necessity Tool to 833-663-1608 (formerly 646-829-1421) or LOCADTR@fideliscare.org.
H. OMH Licensed Inpatient Mental Health Treatment
The facility is required to notify the insurer within 2 business days of admission by calling 1-888-FIDELIS (1-888-343-3547), extension 16072 for Behavioral Health or by fax 833-561-0094 (formerly
8/31/2023
• Posted by Provider Relations
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 7/18/2023. 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).
8/22/2023
• Posted by Provider Relations
Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community.
Articles in this issue:
Provider Access Online Enhancements
Online Provider Representative Directory
Claims Process Improvements
Risk Adjustment Activities
Appeals Process Updates
Provider Office Hours
Please download Fidelis Care Provider Bulletin – Volume 9, Issue 3.
To view our Provider Bulletin Library, please visit: Provider Bulletins.
8/17/2023
• Posted by Provider Relations
The Fidelis Care Pharmacy Team is requesting your feedback! In an effort to identify opportunities for improvement, we are asking all providers to participate in a short survey. Please click on the link below to share your feedback.
Pharmacy Services Provider Survey
Thank you in advance for your participation!
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