Effective October 1, 2021, New Century Health and Fidelis Care are launching a new initiative to safely round drug doses to the nearest vial size, when clinically appropriate, to better manage drug waste. New Century Health has successfully worked with hundreds of oncologists on a similar program for several years in other markets. To make the adoption of this initiative as easy as possible, New Century Health has made enhancements to its Clinical Portal. New Century Health and Fidelis Care encourage your participation in this dose-rounding initiative to demonstrate a commitment to value-based care. Your office can override the dose-rounding
Coronavirus disease 2019 is a new and emerging illness in the United States. The virus causes a disease called COVID-19 that can lead to fever, cough and shortness of breath. There are thousands of confirmed cases in a growing number of countries internationally, and the virus is now spreading in the United States, including New York State. New information, obtained daily, further informs the risk assessment, treatment options, and next steps.
Fidelis Care is closely monitoring the developments across New York State and is following COVID-19 guidance from the New York State Department of Health (SDOH) and Department of Financial Services
The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2021.
The Inpatient Admissions section of the Medicaid, Medicare, Essential Plan, & Metal Level Plan grids now include the following notice regarding TurningPoint Healthcare Solutions:
Inpatient Admissions: All inpatient admissions require an authorization.
Ears, Nose, & Throat (ENT) Surgical Procedures, performed in inpatient, outpatient, physician’s office, and in-home settings, effective 9/20/2021 for dates of service rendered on or after 10/4/2021, prior authorization has been delegated to TurningPoint Healthcare Solutions, LLC. For a list of codes requiring prior authorization, click here. If a CPT code is delegated to
Fidelis Care is pleased to inform you that the most recent 2021 QARR Non-Compliance Report has been posted on Provider Access Online (provider portal). This information is indicative of all encounter data on file with Fidelis Care as of 7/20/2021. Please refer to the most recent "Non-Compliance Report" instruction letter to understand the information being provided on each tab of the Excel Spreadsheet.
Beginning October 1, 2021, Fidelis Care is pleased to announce our expanded partnership with National Imaging Associates, Inc. (NIA) to provide utilization management for Radiation Oncology services and non-emergent, radiology outpatient Medical Specialty Solutions procedures for Fidelis Care members with Medicare, Medicaid, and Qualified Health plans. This program is consistent with industry-wide efforts ensuring that these services provided to our members are consistent with nationally recognized clinical guidelines.
Effective October 1, 2021 radiology services that required prior authorization through eviCore healthcare, will be managed by NIA. Authorizations rendered by eviCore for dates of service prior to 10/1/2021 will remain in effect