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Fidelis Care and the Centene Foundation Award $1.1 Million to The Jed Foundation to Protect the Mental Health of New York’s Youth

Funding will help expand emotional well-being resources, educational workshops, and training programs for community-based organizations that foster communities of care statewide

September 20, 2024, NEW YORK CITY —  Fidelis Care, a leading health insurer providing quality, affordable coverage to New Yorkers, and the Centene Foundation, the philanthropic arm of Centene Corporation, announced today a $1.1 million grant to The Jed Foundation (JED), a national nonprofit that protects emotional health and prevents suicide for teens and young adults.

With this grant, JED will expand its current services, providing at least five youth-serving community-based organizations (CBOs) with consultation or strategic planning services, including expert guidance, educational workshops, and training programs, equipping young people with life skills and connecting them to mental health care when they are in distress.

“We are thrilled to support the vital work of The Jed Foundation with this grant,” said Vincent Marchello, Chief Medical Officer at Fidelis Care. “At Fidelis Care, we recognize the importance of mental health services in creating healthier communities. This investment underscores our commitment to ensuring youth and adolescents have access to the critical support they need to thrive.”

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), it is currently estimated that nearly one in five 12- to 17-year-olds in the United States experience a major depressive episode every year, and almost half of teens 13 to 17 say they would seek out professional help only as a last resort. In New York State, the need for enhanced mental health support for school-aged youth is critical: in 2021, 57% of New York 12- to 17-year-olds with depression had not received any care in the last year.

“JED is grateful to Fidelis Care and the Centene Foundation for their commitment to supporting the emotional well-being of New York youth and for providing the resources to help them thrive,” said John MacPhee, JED Chief Executive Officer. “This partnership will allow us to bring JED’s lifesaving work to community-based organizations across the state and help them build on their mental health safety nets and approaches, while positively impacting the lives of thousands of young people.”

The inaugural group of CBOs includes Bottom Line, an organization that partners with degree-aspiring students from first-generation and low-income backgrounds as they get into and through college and launch mobilizing first careers; Hetrick-Martin Institute, which provides free, year-round programs and services for LGBTQIA+ youth and allies aged 13 to 24 in New York City; and Prep for Prep, which provides first-rate educational, leadership development and professional advancement opportunities for young people of color in New York City.

"Through decades of experience at Bottom Line, we have seen that the condition of a student's mental health plays a significant role in their overall journey to becoming a college graduate and professional,” said Sheneita R. Graham, Director of Culturally Responsive Programming at Bottom Line. “Our role at Bottom Line is to build strong relationships that assist us in determining need and connecting students to resources that will help them thrive personally to persist academically. Partnering with The Jed Foundation grants us the opportunity to expertly assess our mental health policies, processes, and resources to ensure we provide our students with thoughtful, high-quality support."

"Hetrick-Martin Institute is pleased to be working with The Jed Foundation to improve our ability to recognize young people in distress and conduct suicide risk assessments," said Bridget Hughes, Chief Program Officer at Hetrick-Martin Institute.

"We are so grateful to The Jed Foundation for hosting two workshops for our incoming college freshmen as part of our annual College Transition Retreat,” said Corey Rhoades, Director of Undergraduate Affairs at Prep for Prep. “The presenters shared their expertise and tailored the sessions in a way that was uniquely relevant and engaging for our students."

To learn more about ways to provide community-based organizations with consulting, evidence-based best practices, and data-driven guidance to protect youth mental health and prevent suicide, visit JED’s website.

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Screener Program Provides Support to Families Impacted by Social Determinants of Health

SDoH-chart

Fidelis Care’s innovative SDoH screener program was launched two years ago as a grassroots health equity initiative to address conditions in the environments where people are born, live, work, and play that affect their health, well-being, and quality of life. Social Determinants of Health can affect a wide range of health risks and outcomes – particularly among vulnerable populations and in underserved areas.

The screener enables trained Fidelis Care representatives to assess an individual’s immediate needs and challenges related to SDoH through a brief series of questions covering areas such as access to transportation, food, and secure and safe housing. More than 450,000 Fidelis Care members have participated to date.


Click 
here to learn more about the different Social Determinants of Health and find available resources.


More News:


Fidelis Care Practices for Medications Billed Under the Medical Benefit
3/14/2025 • Posted by Provider Relations in Provider News

Fidelis Care’s Pharmacy Services would like to provide a reminder and clarity on how to submit claims for medications billed under the member’s medical benefit, as well as the appropriate Servicing Provider to document when submitting a Pharmacy Prior Authorization request for such medications.

A Pharmacy Prior Authorization Request form can be found on the Fidelis Care website within the Utilization Management Programs section.

 

Documenting the Appropriate Serving Provider

When submitting a Pharmacy Prior Authorization, the Servicing Provider should be the individual provider, facility, or pharmacy who will be supplying and subsequently billing for the supply of the requested medication.  This should be clearly indicated on the request form.

  • “Buy and Bill” – The individual provider or facility administering the medication will also be supplying the medication.  In this case the name of the provider/facility and their NPI or TIN should be provided on the request form.
  • “Drop Shipment” – A Specialty Pharmacy will supply the medication to the provider who will be administering the medication.  In this case the name of the Specialty Pharmacy and their NPI or TIN should be provided on the request form.

 

Submitting A Claim

The individual provider, facility, or pharmacy supplying the medication, as indicated on the authorization request form, should be the entity submitting the claim to Fidelis Care for the supply of the requested medication.  It is expected that only one claim should be submitted for the supply of the medication.  This claim submission should be initiated by the Servicing Provider indicated on the request form.

  • “Buy and Bill” – It is expected that the claim for the supply of the medication is submitted by the individual provider/facility indicated on the request form, who is both supplying and administering the medication to the member.  Claim submissions should also include a claim line for the appropriate administration CPT code that corresponds to the medication administered to the member.  Please ensure that the individual provider and the facility the member is receiving services through do not both bill for the supply of the medication.
  • “Drop Shipment” – It is expected that the Specialty Pharmacy indicated on the request form submits the claim for the supply of the medication to Fidelis Care.  The individual provider or the facility solely administering the medication should not submit a claim for the supply of the medication as this service is being provided by the Specialty Pharmacy.

 

For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.


Fidelis Care Practices for Medications Billed Under the Medical Benefit
3/14/2025 • Posted by Provider Relations in Provider News

Fidelis Care’s Pharmacy Services would like to provide a reminder and clarity on how to submit claims for medications billed under the member’s medical benefit, as well as the appropriate Servicing Provider to document when submitting a Pharmacy Prior Authorization request for such medications.

A Pharmacy Prior Authorization Request form can be found on the Fidelis Care website within the Utilization Management Programs section.

 

Documenting the Appropriate Serving Provider

When submitting a Pharmacy Prior Authorization, the Servicing Provider should be the individual provider, facility, or pharmacy who will be supplying and subsequently billing for the supply of the requested medication.  This should be clearly indicated on the request form.

  • “Buy and Bill” – The individual provider or facility administering the medication will also be supplying the medication.  In this case the name of the provider/facility and their NPI or TIN should be provided on the request form.
  • “Drop Shipment” – A Specialty Pharmacy will supply the medication to the provider who will be administering the medication.  In this case the name of the Specialty Pharmacy and their NPI or TIN should be provided on the request form.

 

Submitting A Claim

The individual provider, facility, or pharmacy supplying the medication, as indicated on the authorization request form, should be the entity submitting the claim to Fidelis Care for the supply of the requested medication.  It is expected that only one claim should be submitted for the supply of the medication.  This claim submission should be initiated by the Servicing Provider indicated on the request form.

  • “Buy and Bill” – It is expected that the claim for the supply of the medication is submitted by the individual provider/facility indicated on the request form, who is both supplying and administering the medication to the member.  Claim submissions should also include a claim line for the appropriate administration CPT code that corresponds to the medication administered to the member.  Please ensure that the individual provider and the facility the member is receiving services through do not both bill for the supply of the medication.
  • “Drop Shipment” – It is expected that the Specialty Pharmacy indicated on the request form submits the claim for the supply of the medication to Fidelis Care.  The individual provider or the facility solely administering the medication should not submit a claim for the supply of the medication as this service is being provided by the Specialty Pharmacy.

 

For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.