TurningPoint Healthcare Solutions Authorization Program Beginning
12/13/2019
•
Posted by Provider Relations
Fidelis Care is pleased to announce the launch of a new and innovative Musculoskeletal Surgical Quality and Safety Management Program, effective [ ] The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Fidelis Care members undergoing Musculoskeletal Surgical Procedures. Prior Authorization for medical necessity and appropriate length of stay (when applicable) has been delegated to TurningPoint Healthcare Solutions, LLC. and will be required for orthopedic surgical procedures and spinal surgical procedures in both inpatient and outpatient settings.
The program will include the following Fidelis Care health insurance products:
- Medicaid Managed Care (NYM)
- Child Health Plus (CHP)
- Medicare Advantage (MA)
- Dual Advantage (DUAL)
- HealthierLife (HARP)
- Metal-Level Products (Qualified Health Plan)
- Essential Plan (EP)
- Medicaid Advantage Plus (MAP)
TurningPoint’s Utilization Management & Precertification Contact Information:
TurningPoint will begin accepting requests for prior authorization beginning [ ], for dates of service [ ], and beyond.
Further details regarding this new prior authorization program can be found by viewing the resource links below.
TurningPoint Healthcare Solutions Provider Notice
TurningPoint Healthcare Solutions CPT Codes
Fidelis Care and TurningPoint Healthcare Solutions, LLC welcomes providers to attend an educational webinar. Be sure to register for a TurningPoint Surgical Quality and Safety Management provider webinar session as listed below. You will only need to attend one of these educational sessions.
[Insert new provider webinar schedule]
After registering, you will receive a confirmation email containing information about joining the webinar.
If you have any questions, please contact the Fidelis Care Provider Call Center at 1-888-FIDELIS (1-888-343-3547).