Welcome, Brokers!

Fidelis Care has updated its 30-Day Readmission Payment Policy which establishes reimbursement guidelines for hospital readmissions occurring within thirty (30) days of discharge. This policy replaces the previous 14-Day Readmission Payment Policy and expands the readmission review period to thirty (30) days following discharge. The updated policy, effective October 1, 2026, outlines circumstances when a readmission may not qualify for separate reimbursement.

Certain readmissions may be reviewed to determine whether they meet Fidelis Care’s reimbursement criteria. When applicable, separate payment for the readmission may be denied because the readmission is considered an extension of the initial admission.

Providers should review the policy and follow their standard Provider Relations or Claims support process with any questions.