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TurningPoint Healthcare Solutions Authorization Program Beginning Monday, December 23, 2019
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 on December 23, 2019. 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 Plans)
  • Essential Plan (EP)
  • Medicaid Advantage Plus (MAP)

TurningPoint’s Utilization Management & Precertification Contact Information:

TurningPoint will begin accepting requests for prior authorization beginning December 23, 2019,  for dates of service December 23, 2019 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 Training Manual
TurningPoint Healthcare Solutions FAQ

TurningPoint Healthcare Solutions CPT Codes

Fidelis Care and TurningPoint Healthcare Solutions, LLC welcome providers to attend an educational webinar. Be sure to register for a TurningPoint Surgical Quality and Safety Management provider webinar session listed below. You will only need to attend one of these educational sessions.

Registration URL

https://attendee.gotowebinar.com/rt/2531706190825898507

Webinar ID: 417-123-475

Training Dates:
December 16, 2019 9:00 AM EST
December 17, 2019 9:00 AM EST
December 17, 2019 12:30 PM EST
December 18, 2019 9:00 AM EST
December 18, 2019 11:00 AM EST
December 19, 2019 9:00 AM EST
December 19, 2019 1:00 PM EST
December 20, 2019 9:00 AM EST
December 20, 2019 1:00 PM EST
December 23, 2019 9:00 AM EST
December 24, 2019 9:00 AM EST

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).

 

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Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Utilization Management (UM)

Find information and links to external vendor authorization programs as well as links to internal Fidelis Care prior authorization resources.

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