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Wellcare and Conversio Health have partnered together to bring providers a comprehensive COPD condition management program to support managing high-risk patients with chronic respiratory conditions—target patient population includes members with a history of ED visits or hospitalizations. Conversio Health services are available to Wellcare by Fidelis Care and Wellcare members. Conversio Health’s expert team of clinical pharmacists, respiratory therapists, and health coaches are focused on giving providers and patients the best quality of service available to help them breathe better.  These services are at no cost to patients and, include: COPD medication therapy optimization Improvement of medication adherence Providing medication affordability,

Earlier this month Fidelis Care notified providers that, pursuant to the regulatory requirements defined in Article 44 of the New York State Public Health Law for all Managed Care Organizations, it was implementing a change to its appeals process by requiring the submission of written member consent.  The change was scheduled to become effective on June 1, 2025.    NYSDOH has informed Fidelis that it is currently reviewing the policy and advised Fidelis Care to postpone its implementation.  Therefore, Fidelis Care is rescinding the implementation of the policy until further notice and will provide an update when more information is available.   For additional

Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. The NYSDOH requires that certain Access and Availability Standards be met by PCPs, OB/GYNs, specialists, and behavioral health providers where applicable. Click here to view the full list of standards, including situations and timeframes.   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here. 

Effective May 1, 2025, the provision of School-Based Health Center (SBHC) and SBHC-Dental (SBHC-D) services will be incorporated into the Mainstream Medicaid Managed Care (MMC) and HIV Special Needs Plan (HIV SNP) benefit package. Therefore, Fidelis Care will be responsible for reimbursing SBHC operators for SBHC services provided to Fidelis Care members. The goal of the transition is to maintain access to these critical SBHC and SBHC-D services while integrating the services into the larger health care delivery system. It is anticipated that the integration of SBHC and SBHC-D services within the existing managed care framework, and coordination of services with

The Fidelis Care Provider Relations Department is committed to building strong and lasting relationships with our providers and their staff.  To foster this partnership, we have assigned a Provider Relations Specialist to communicate important information and provide support to our providers. Please be sure to reference our Contact Your Designated Provider Relations Specialist web page if you do not know the name of the specialist assigned to your provider group.  To note, there are times that we adjust territory assignments to better serve our providers, so it important to periodically verify your assigned specialist. If you are unable to determine the identity