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IMPORTANT: 2023MY QARR/HEDIS Medical Record Review - Second Requests are Now Available!
3/19/2024 • Posted by Provider Relations

Fidelis Care is pleased to inform you that the medical record request letter and details for 2023 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible. Thank you in advance for your cooperation on this important matter. Should you have any questions or concerns, please do not hesitate to contact Fidelis Care’s Provider Call Center at 1-888-FIDELIS (1-888-343-3547).

As part of the New York State Quality Assurance Reporting Requirements (QARR), National Committee for Quality Assurance (NCQA), and HEDIS reporting requirements for the Centers for Medicare and Medicaid Services (CMS), Fidelis Care and Wellcare by Fidelis Care annually reviews charts of selected members to assess the quality of clinical care. Since Fidelis Care is a covered entity under HIPAA, a special authorization is NOT needed to process this request.

Provider Actions

PREFERRED METHOD – Microsoft 365

The Microsoft 365 account is an online tool that can be utilized to submit your labs/encounters files and medical records securely. If you don’t already have access, all that is needed is your provider group name, email address(s), and contact name(s) for those who will have access to the account. Please contact your assigned Fidelis Care Provider Partnership Associate (PPA) to have your account setup. A pdf document with instructions will be sent by the PPA upon notifying them you would like to utilize this tool.

Microsoft 365 Encounters and Labs folder 

Please submit the Encounters and Labs data using the custom form your Fidelis Care Provider Partnership Associate provided to you and place in the Microsoft 365 Labs and Encounters folder.

ALTERNATIVE METHODS

Please submit a copy of the member’s medical record and the completed Medical Record Request list with authorized signature and date through one of the following methods:

Microsoft 365 Medical Records folder:  Preferred method if sending pdf documents.

Fax:        1-877-644-5921

E-mail: QARRGMRO@fideliscare.org
Mail***: Fidelis Care

                Attention: QARR/HEDIS MEDICAL RECORDS

            31st Floor Room 3113A

                25-01 Jackson Ave.

                Long Island City, NY 11101

*** Please utilize mail only if you cannot send medical records by the other three methods.

 

Please help us meet NCQA deadlines by submitting all requested information by 4/12/2024.

 

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Social Care Network

Starting January 1, 2025, members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans will have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.

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Utilization Management (UM)

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