Welcome, Brokers!

NY State of Health has announced upcoming changes to the Essential Plan 5, effective July 1, 2026. To help current enrollees prepare, Fidelis Care members have started receiving official notifications from the state outlining these updates. To support you in addressing patient questions, Fidelis Care has compiled a list of frequently asked questions (FAQs) to guide your conversations and provide clarity. FAQs I have patients saying they received a letter about their Essential Plan coverage ending. What is going on? Essential Plan 5 members recently received a letter from NY State of Health notifying them that EP5 will end on July 1, 2026.

Fidelis Care will host three Provider Office Hours in November 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 – November 2025   Topic: Fidelis Care – Back to Basics When:  Thursday, November 13th – 9AM – 10AM EST Click here to register*   Topic: Fidelis Care and Wellcare - Quality Programs When:  Wednesday, November 19th – 10 AM – 11 AM EST

As we approach the final quarter of the year, we’re entering a critical phase of the Continuity of Care (CoC) program. Our shared goal remains clear: to ensure patients receive timely, high-quality care while closing the most impactful clinical gaps by December 31. To support you in this effort, we’ve refined the appointment agenda to focus on the most urgent and actionable opportunities with a particular emphasis on risk adjustment conditions. This streamlined approach is designed to: Prioritize the highest-value clinical care gaps for closure; Maximize your time during each patient encounter to focus on the more critical clinical and

Fidelis Care would like to inform providers that we are unable to accept calls from Artificial Intelligence (AI) entities or other automated systems to verify claim status, obtain remittance information, or respond to any other inquiries.  Fidelis Care representatives may only engage with a live person to verify PHI and ensure HIPAA compliance.   Providers are also encouraged to use the Fidelis Care Provider Portal to obtain needed information. For more information on the Provider Portal, please visit:  https://www.fideliscare.org/Provider/Provider-Access-Online-Resources   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To identify your

Fidelis Care would like to remind providers of a postpartum visit incentive being offered through the New York State (NYS) Medicaid program and inform providers of extended claim submission dates. This program will provide an additional payment to the current NYS Medicaid reimbursement for comprehensive, timely postpartum visits provided to Medicaid Managed Care (MMC)/Fidelis Care Medicaid members. Providers who delivered a person-centered comprehensive postpartum visit as outlined by the American College of Obstetricians and Gynecologists clinical guidelines, including a postpartum depression screen, to Fidelis Care members within 12 weeks of the date of delivery will receive an additional payment of $208.55.