01.09.2023
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2023.
The Medicaid, Medicare, Essential Plan and Metal-Level grids have been updated as follows:
E. OASAS Licensed Inpatient Substance Use Disorder Treatment:
The facility may fax or email the OASAS Appendix A Notification Form and OASAS LOCADTR Medical Necessity Tool to 833-663-1608 (formerly 646-829-1421) or LOCADTR@fideliscare.org.
H. OMH Licensed Inpatient Mental Health Treatment
The facility is required to notify the insurer within 2 business days of admission by calling 1-888-FIDELIS (1-888-343-3547), extension 16072 for Behavioral Health or by fax 833-561-0094 (formerly
31.08.2023
• Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2023 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 7/18/2023. Please refer to the most recent "Non-Compliance Report" instruction letter to understand the information being provided on each tab of the Excel Spreadsheet. Please notify any staff involved with quality management and advise that these documents have been posted. If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
22.08.2023
• Posted by Provider Relations
Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community.
Articles in this issue:
Provider Access Online Enhancements
Online Provider Representative Directory
Claims Process Improvements
Risk Adjustment Activities
Appeals Process Updates
Provider Office Hours
Please download Fidelis Care Provider Bulletin – Volume 9, Issue 3.
To view our Provider Bulletin Library, please visit: Provider Bulletins.
17.08.2023
• Posted by Provider Relations
The Fidelis Care Pharmacy Team is requesting your feedback! In an effort to identify opportunities for improvement, we are asking all providers to participate in a short survey. Please click on the link below to share your feedback.
Pharmacy Services Provider Survey
Thank you in advance for your participation!
15.08.2023
• Posted by Provider Relations
Earlier this year, the Biden Administration announced that the federal Public Health Emergency (PHE) related to the COVID-19 pandemic ended on May 11, 2023.
During the PHE, we followed guidance from the Centers for Medicaid & Medicare Services (CMS) and instituted temporary waivers for select services. This action ensured that critical care could be quickly delivered to our members during a time of heightened need. Beginning May 12, 2023, these temporary waivers expired, and our members’ Medicare plan benefits are reinstated for the following services:
Service
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