Добро пожаловать, Брокеры!

The following section of the Fidelis Care authorization grids have been updated effective September 1, 2025.   The following code has been updated on the Medicare Authorization Grid and requires prior authorization:   Durable Medical Equipment/Supplies:            E1012 Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each   The following section of the Fidelis Care authorization grids have been updated effective July 1, 2025.   The following codes have been updated on the Medicare Authorization Grid and no longer require prior authorization:   Service Category Services

Fidelis Care will host three Provider Office Hours in August 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 – August 2025   Topic: Fidelis Care – Back to Basics When:  Thursday, August 14th – 12PM – 1PM EST Click here to register*   Topic: Fidelis Care and WellCare Quality Programs When:  Wednesday, August 20th – 10AM – 11AM EST Click

The following section of the Fidelis Care authorization grids have been updated effective September 1, 2025.   The following code has been updated on the Essential Plan and Metal-Level Products Authorization Grids: Durable Medical Equipment/Supplies:                                1.      These DME codes do not require an authorization: A7046                                                       The following codes have been updated on the Medicare Authorization Grid: A.    Durable Medical Equipment/Supplies:            1.      These DME codes do not require an authorization: A4557, A5500, A6530, A7046, E0443, E0730, E0849, E0951, E0955, E0956, E0961, E0971, E0973, E0990, E1392, E2210, E2365, E2601, E2607, E2624, K0001, K0019, K0040, K0195, K0738, L5685              2.       The following orthotic codes

Fidelis care would like to inform all participating providers that we will be conducting an Access & Availability Survey in the coming weeks. This survey ensures that providers are meeting NYS mandated Access & Availability standards for all Fidelis Care members. The survey will assess: Timeliness of appointment scheduling based on appointment type.  For example: Routine Care Urgent Care Non-Urgent Sick Visit After Hours Availability  Accuracy of provider directory information. This applies to Primary Care Providers, OB/GYNs, Oncologists, and Behavioral Health Providers. Typical reasons for non-compliance include: Appointment scheduling timeframes do not meet state guidelines. Office

As part of New York’s Medicaid Redesign Team (MRT) initiative, the NY 1115 Waiver introduced the Social Care Networks (SCN) Program, a transformative model focused on integrating social care into healthcare delivery. The SCN program encourages partnerships across health and social services to address Medicaid members' diverse needs, such as food insecurity, housing instability, and lack of transportation. Many of these services may become reimbursable to a member under the provision of this waiver.   How the SCN Program Works: Eligible Medicaid, MAP, MLTC, and HARP Members have access to a wide range of free services through the local Social Care Network (SCN),