Fidelis Care would like to share some exciting news with you regarding the brand name of our Qualified Health Plans (QHPs).
As of January 1, 2024, all Fidelis Care QHPs will be known as Ambetter from Fidelis Care. Fidelis Care’s Medicaid Managed Care (MMC), Child Health Plus (CHP), Managed Long Term Care (MLTC), Health and Recovery Plan (HARP), and Essential Plan (EP) will continue under the Fidelis Care brand.
This fall, you will begin to receive materials with the new Ambetter from Fidelis Care branding as we transition to the new name for our QHP products.
You do not need to take any
Fidelis Care is pleased to inform you that the most recent 2023 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 8/21/2023. Please refer to the most recent "Non-Compliance Report" instruction letter to understand the information being provided on each tab of the Excel Spreadsheet. Please notify any staff involved with quality management and advise that these documents have been posted. If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
Fidelis Care and Wellcare By Fidelis Care are pleased to inform you that we have contracted with the vendor, AdvantMed, to assist in facilitating the retrieval of medical records for our Risk Adjustment Retrospective Chart Review program. We appreciate your cooperation with any chart review efforts.
These programs utilize chart review to look back in time for missing data.
This allows Fidelis Care and Wellcare By Fidelis Care to meet the New York State Department of Health requirement that health plans submit complete diagnostic information regarding their members.
To meet this requirement, we are requesting your cooperation to facilitate standard
The following section of the Fidelis Care authorization grid has been updated effective November 1, 2023.
The following code has been updated on the Medicare Authorization Grid and requires prior authorization:
C9293 glucarpidase (Voraxaze)
Visit: Authorization Grids
Fidelis Care is aware that some providers are having access issues with the Provider Portal. The IT Team is actively working on a solution and we will advise you when the issues have been resolved.
For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist. Thank you for being a valued Fidelis Care partner in the provision of quality care.