Last Week
• Posted by Provider Relations
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Provider News
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.
2025/6/5
• Posted by Provider Relations
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Provider News
Fidelis Care received notice from New York State Office of Addiction Services and Support (OASAS), that providers are required to bill OTP bundle services under the APG methodology effective November 3, 2025. This applies to Medicaid Managed Care (MMC) plans, including Mainstream MMC plans, HIV Special Needs Plans (HIV SNPs), and Health and Recovery Plans (HARPs).
Initiative Timeline:
Beginning July 1, 2024, providers were given the option to bill OTP bundle services either under the existing OTP bundle rate codes or the APG methodology. The May memorandum also indicated that OASAS would zero out the bundle rate codes (7969-7976) after a
2025/6/3
• Posted by Provider Relations
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Provider News
You asked and we listened! Fidelis Care is pleased to announce that Health Savings Unit (HSU) Recovery letters are now available on Provider Access Online, Fidelis Care’s Provider Portal, in the File Download section.
To access the HSU letters:
Use the menu on the left of the Provider Access Online home page to navigate to the File Downloads section.
On the File Download page, providers can search by File Type and File Created date range.
Click on the letter you would like to download. HSU letters will include only the provider’s name and provider identification number.
To dispute an HSU retraction, providers
2025/6/2
• Posted by Provider Relations
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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
Medications that are administered to a member during an outpatient visit are covered under the member’s medical benefit. The authorization requests and claims for these medications should be processed through Fidelis Care using the guidelines and tips below, for all Lines of Business.
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.
2025/6/2
• Posted by Provider Relations
• in
Provider News,
Provider Quality
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:
· Don't Forget to Use the Authorization Look Up Tool
· Notify Fidelis Care of Any Changes to Your Practice
· Access and Availability Standards
· Annual Wellness Visits and Follow-Up Patient Reminders
· Importance of Submitting Medical Records
· Support Your Patients in Managing Diabetes
Please download Fidelis Care Provider Bulletin – Volume 11, Issue 2.
To view our Provider Bulletin Library, please visit: Provider Bulletins.
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