Yesterday
• Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective June 1, 2026.
The following code has updated been on the Medicaid, CHP, Essential Plan, and Ambetter Metal-Level Plans Authorization Grids and requires prior authorization:
Q5111 pegfilgrastim-cbqv (udenyca)
Visit: Authorization Grids
Tuesday
• Posted by Provider Relations
Access to quality care is essential to reducing health disparities and improving the quality and length of life for all New Yorkers.
The New York State Department of Health (NYSDOH) and CMS require that specific Access and Availability Standards be met by Primary Care Providers (PCPs), OB/GYNs, Specialists, and Behavioral Health Providers.
To ensure compliance, Fidelis Care conducts regular Access & Availability surveys to confirm providers meet these state-mandated standards for all Fidelis Care members.
The survey evaluates:
Timeliness of appointment scheduling by appointment type
Accuracy of provider directory listings
Responsiveness of phone systems and office staff
Common issues leading to non-compliance include:
Appointment
Tuesday
• Posted by Provider Relations
Annual cultural competency training for participating providers is required by the New York State Department of Health. At this time, The New York State DOH will only accept the approved training offered by the United States Department of Health and Human Services (HHS), Office of Minority Health education program, Think Cultural Health, to fulfill the requirement for provider annual cultural competency training.*
Once the cultural competency training has been completed, providers need to verify completion of the program by emailing the Cultural Competency Attestation Form to:
CulturalCompetencyTrainingAttestation@fideliscare.org.
The required Cultural Competency Training needs to be completed annually by December 31st. Providers that completed
Tuesday
• Posted by Provider Relations
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
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