5/31/2024
• Posted by Provider Relations
Fidelis Care is pleased to inform you that the most recent 2024 QARR/HEDIS Care Gap 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 4/21/2024. This report provides you with the opportunity to review preventative services for which Fidelis does not show your members as receiving in the measurement period. We strongly suggest that you review the report for opportunities to either render the service, schedule the service to be done before 12/31/24 or if previously performed, submit supplemental data by 2/1/25. Please notify
5/29/2024
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective July 1, 2024.
The following codes have been added on the Medicaid, Essential Plan, and Ambetter By Fidelis Care Metal-Level Products Authorization Grids and require prior authorization:
Q5137 ustekinumab-auub (Wezlana), biosimilar, subQ
Q5138 ustekinumab-auub (Wezlana), biosimilar, intravenous
J0911 Instillation, taurolidine and heparin sodium (hemodialysis)
J1748 infliximab-dyyb (Zymfentra)
J2267 Injection, mirikizumab-mrkz
J3247 Injection, secukinumab, intravenous
J3263 Injection, toripalimab-tpzi
J3393 Injection, betibeglogene autotemcel
J3394 Injection, lovotibeglogene autotemcel
J7171 Injection, Adamts13, recombinant-krhn
J7355 Injection, traveoprost, intracameral implant
J8611 Methotrexate (jylamvo)
J8612 Methotrexate (Xatmep)
J9361 Injection, efbemalenograstim alfa-vuxw
Evolent Oncology Program (New Century Health) will require review of the following codes for Medicaid, Medicare, Essential Plans and Metal-Level Products:
J2468 Injection, palonsetron hydrochloride (avyxa)
J3263 Injection, toripalimab-tpzi
J8611 Methotrexate
5/21/2024
• Posted by Provider Relations
Fidelis Care will host two Provider Office Hours in June 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions.
Provider Office Hours – June 2024
Topic: Back to Basics – Doing Business with Fidelis Care
When: Thursday, June 13th – 9AM – 10AM EST
Click here to register*
Topic: Credentialing and Provider Data Management
When: Thursday, June 27th – 3PM – 4PM EST
Click here to register*
5/20/2024
• Posted by Provider Relations
Due to technical issues, providers may have been experiencing difficulty accessing Fidelis Care’s Provider Portal. Full functionality of the portal has now been restored. Please log in as you normally would. We appreciate your patience as we resolved the issue.
If you have any questions, 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.
5/17/2024
• Posted by Provider Relations
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.
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