¡Bienvenidos, proveedores!

Fidelis Care would like to inform our providers of plan changes that will be effective January 1, 2025.      Wellcare By Fidelis Care   Wellcare Fidelis Dual Plus (HMO D-SNP) - Plan 008 Effective January 1, 2025, Fidelis Care members currently in this plan will be enrolled in Wellcare Fidelis Dual Plus (HMO D-SNP) – Plan 003, unless the member chooses another plan.  

Effective January 1, 2025, Social Adult Day Care (SADC) transportation will remain a covered benefit under MLTC Plans and SADCs will no longer have the option of their transportation being carved out to fee-for-service. All SADCs will be responsible for managing their own transportation. SADC Programs can opt to use their own vehicles or contract directly with transportation vendors to secure transportation of SADC members to SADC programs. Before January 1, 2025, SADCs must transition any members whose trips to and from the SADC are arranged through their contracted MLTCP, MAP plan or through MAS to having their trips arranged and

Fidelis Care would like to inform providers of a federal amendment to the Consolidated Appropriations Act, 2023, that requires states to provide 12-months of continuous eligibility (CE) for children enrolled in Child Health Plus (CHP) plans and under the age of 19.   While New York currently has 12-months of continuous coverage in CHP, it has state specific exceptions which are no longer permitted under federal requirements. A child can only be terminated during the 12-month CE period due to one of the following exceptions: 1. The child reaches the age of 19; 2. The child or parent/guardian requests voluntary disenrollment from the program; 3.

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 9/17/2024.  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

Fidelis Care will host two Provider Office Hours in November 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions. Provider Office Hours – November 2024   Topic: Back to Basics – Doing Business with Fidelis Care When:  Thursday, November 14th – 12PM – 1PM EST Click here to register*   Topic: Fidelis Care and Wellcare Quality Programs When:  Thursday, November 21st – 3PM – 4PM EST Click

Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community. Articles in this issue: Smoking Cessation Products and Medications Helping Patients with Chemical Dependency Appropriate Use of GLP-1 Agonists Preventive Cancer Screenings and Vaccinations Cardiovascular Disease and Statis Therapy    Please download Fidelis Care Provider Bulletin – Volume 10, Issue 4.   To view our Provider Bulletin Library, please visit: Provider Bulletins.