¡Bienvenidos, proveedores!

Fidelis Care would like to make providers aware of a new resource available.  Choosing Wisely is an initiative of the ABIM Foundation that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments, and procedures. Choosing Wisely provides learning modules for clinicians to enhance communication skills, avoid unnecessary testing and overcome barriers to delivering high-value care.   Fidelis Care offers providers simplified access to Choosing Wisely through our website or by using the following link - Choosing Wisely: An Initiative of the ABIM Foundation.   For additional questions, or if we can be of assistance in any way, please contact your Fidelis

The Centers for Medicare and Medicaid Services (CMS) requires that providers receive Medicare Special Needs Program (SNP) Model of Care (MOC) Training annually.  As part of our ongoing commitment to access, quality of service, and quality of care for our members, Fidelis Care provides this training annually and during the new contract process to all network providers, as well as to providers who regularly see our SNP members.    The training module can be accessed by logging into our provider portal, please visit Provider Access Online.  After logging in, if training and attestation is required, you will receive a notification on the Home Page. 

Fidelis Care will host three Provider Office Hours in August 2024. During the webinar, Fidelis Care staff will be available to share information, explain different resources, and answer your questions. Provider Office Hours – August 2024 Topic: Back to Basics – Doing Business with Fidelis Care When:  Thursday, August 8th – 9AM – 10AM EST Click here to register*     Topic: Claims Overview When:  Thursday, August 22nd – 3PM – 4PM EST Click here to register*

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 6/18/2024.  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

Effective June 24, 2024, Fidelis Care implemented changes to our Peer-to-Peer process.  In response to inquiries from our providers, we are providing the following clarification and reminder.   Clarification – Medicare:  To comply with CMS regulations, Fidelis Care is no longer providing a Post-Decision Peer-to-Peer review for most services pertaining to Medicare members. It is important to note that submitting a formal appeal will be necessary for any post-decision reviews.  Note that a concurrent peer-to-peer discussion can be provided for emergent hospital admissions only, if requested while the member is still in the hospital OR if requested within 2 business days of