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Fidelis Care обслуживает более 1,7 миллиона детей и взрослых всех возрастов, что делает нас одним из крупнейших планов медицинского страхования в штате Нью-Йорк. Мы были основаны на убеждении, что все жители Нью-Йорка должны иметь доступ к качественному и доступному медицинскому страхованию, и наша миссия помогать другим лежит в основе всего, что мы делаем. 

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29.09.2025 • Posted by Provider Relations • in Provider News, Provider Quality
Timely follow-up care after a mental health discharge is a vital component of recovery. Clinical guidelines recommend that individuals discharged from an emergency department (ED) or inpatient setting receive a follow-up visit within seven (7) days. This window is crucial for maintaining continuity of care, reducing the risk of readmission, and supporting long-term wellness. To help meet this need, Fidelis Care has partnered with Brave Health, a virtual behavioral health provider offering accessible services such as therapy, psychiatry, and care coordination. Brave Health’s telehealth model allows members to receive care from the comfort of their homes, making it easier to stay
29.09.2025 • Posted by Provider Relations • in Provider News, Provider Quality
In today’s healthcare landscape, effective coordination between primary care providers (PCPs) and specialists is essential for delivering safe, timely, and patient-centered care. When providers collaborate, patients benefit from accurate diagnoses, appropriate treatments, and a smoother care experience. Why It Matters PCPs manage preventive care and chronic conditions, serving as the first point of contact for members. When specialized care is needed, such as for heart disease or skin conditions, specialists become key partners. Without coordination, patients may face delays, conflicting advice, medication errors, and increased healthcare costs. Referrals: A Vital Link Referrals are more than administrative steps; they ensure patients receive the right care
29.09.2025 • Posted by Provider Relations • in Provider News, Provider Quality
The role of primary care providers in preventing vaccine-preventable diseases includes more than administering vaccines. Timely documentation in New York’s immunization registries (New York State Immunization Information System (NYSIIS) for providers outside New York City, and the Citywide Immunization Registry (CIR) for providers within New York City) is essential to protecting children and supporting public health. Why Timely Reporting Matters Accurate updates to NYSIIS and CIR: Ensure continuity of care Prevent missed or duplicate vaccinations Support public health surveillance Improve office efficiency Comply with New York State law (reporting required within 14 days) The Value of Timely Vaccination Vaccines are most effective when given
29.09.2025 • Posted by Provider Relations • in Provider News
Fidelis Care’s Pharmacy Services would like to provide clarification on how medications are covered under member’s medical and pharmacy benefits.   Medications Covered Under Fidelis Care Medical Benefit Physician Administered Drugs – medications administered to a member during an outpatient visit Providers obtain medication via “buy-and-bill” or shipment to their practice site from a vendor of their choosing. Coverage is dictated by Fidelis Care Authorization Grids, Prior Authorization Lookup Tool and/or Evolent Specialty Services (formerly NCH) Authorization Grids (Oncology Regimen Specific). Medical Benefit Authorization Grids are plan specific. If a medication is listed on one of the above authorization grids/tools, an authorization
26.09.2025 • Posted by Provider Relations • in Provider News, Provider Quality
Fidelis Care will host three Provider Office Hours in October 2025. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – October 2025   Topic: Fidelis Care Tools & Resources Overview When:  Thursday, October 9th – 12PM – 1PM EST Click here to register*   Topic: Fidelis Care and Wellcare - Quality Programs When:  Wednesday, October 15th – 10 AM – 11 AM EST
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