Today
• 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!
Today
• Posted by Provider Relations
As your health plan partner, Fidelis Care would like to share critical information about changes coming soon in Medicaid Managed Care, Essential Plan, Child Health Plus, HARP, and MLTC programs across New York State.
Based on the Consolidated Appropriations Act, 2023, enacted on December 29, 2022, the continuous enrollment condition that started during the COVID-19 pandemic is coming to an end, and patients will need to act to stay insured - for the first time in more than three years.
Most patients in Medicaid Managed Care, Essential Plan, Child Health Plus, HARP, or MLTC plans will need to renew their health insurance
Friday
• Posted by Provider Relations
Fidelis Care is pleased to announce the new Quality Care Incentives (QCI) Brochure is now available on Provider Access Online. Once logged in, please navigate to the File Downloads section to access the brochure.
If you have any questions regarding Fidelis Care’s Quality Care Incentives, please contact your Provider Partnership Associate through any of our regional office numbers.
Friday
• Posted by Provider Relations
Fidelis Care will be hosting our first ever educational webinar series for our Health Home partners entitled “Wellness 360 for Health Homes”. Health Homes provide community-based care management for Medicaid recipients with chronic medical and behavioral health conditions. The webinars will offer a unique opportunity to learn more about Fidelis Care’s Care Management and essential components of monitoring HEDIS measures for mutual members. Each training event will focus on a topic specific to measures in scope.
Training Events:
Topic: Dealing with Pharmacy Issues
Date: June 14, 2023
Time: 10-11 AM
Registration Link: https://centene.zoom.us/webinar/register/WN_sjhbIGRJRPaixE9S0fQYaw
Topic: Medication and Substance Use Disorders
Date: September 8, 2023
Time: 10-11 AM
Registration Link: https://centene.zoom.us/webinar/register/WN_UGmPrYovQG-B0M7U-wS9-w
Topic: Smoking
Friday
• Posted by Provider Relations
Fidelis Care has received new guidance from the New York State Office of Mental Health (OMH) regarding Assertive Community Treatment (ACT) utilization management for requested services.
This new guidance will no longer require providers to obtain prior authorization from Fidelis Care for ACT services using code H0040. Providers will need to follow the authorization process below when seeking ACT services for Fidelis Care members.
Utilization Management for ACT – Authorization Process
Effective June 1, 2023, Level of Service Determinations (LOSD) and prior authorization previously completed by New York State (NYS) Medicaid Managed Care Organizations (MMCOs) is no longer required. Individuals, including MMCO
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