Reminder: Ambetter from Fidelis Care – Site of Care Optimization Program for Infusion Services
2025/9/29
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Posted by Provider Relations
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Provider News
Effective October 1, 2025, Ambetter from Fidelis Care will implement a Site of Care Optimization Program to promote cost-effective, high-quality care for members receiving infusion therapies.
Under this initiative, providers will be asked to transition eligible members from outpatient hospital infusion settings to clinically appropriate home infusion or ambulatory infusion suite (AIS) options. Outreach to participating providers will begin in October via fax or phone to gather preferred site-of-care selections.
National Infusion Providers: AcariaHealth, Accredo, KabaFusion, Option Care
Local Infusion Providers: Prime Infusions, OptumCare, CNY Infusion, Soleo Health
The above are a few examples of contracted providers. Visit fideliscare.org/Find-A-Doctor#/search for a complete list of contracted providers.
Program Highlights:
- Focuses on therapies for conditions such as immune globulin disorders, Crohn’s disease, rheumatoid arthritis, psoriasis, multiple sclerosis, and rare diseases.
- Supports improved access for members in rural or underserved communities.
- Aligns with clinical and payer guidelines for appropriate site of care.
Benefits of Alternate Infusion Settings:
- Enhanced patient experience in more comfortable environments
- Reduced risk of hospital-acquired infections
- Greater scheduling flexibility, including evenings and weekends
- Lower overall cost of care for members and the healthcare system
Infusion Nurses Are Trained To:
- Monitor treatment adherence and manage emergency protocols
- Provide patient education and follow CDC infection prevention guidelines
- Deliver Pediatric Advanced Life Support (PALS) care for children
Provider Support: Our team will collaborate with providers to:
- Review member eligibility and clinical appropriateness
- Facilitate referrals to alternate infusion sites
- Ensure continuity of care with minimal disruption
Additional details about the Site of Care Optimization Program can be found at: https://www.fideliscare.org/Provider/Provider-Resources/Pharmacy-Services/Site-of-Care-Optimization
For questions or member-specific discussions, please contact our Pharmacy Provider Liaison at CPS_UM_SOC@centene.com or call (866) 861-6269. If unavailable, ask for the Pharmacy Operations Manager.
Thank you for your continued partnership in delivering high-quality, cost-effective care to Ambetter members.