IMPORTANT: 2023MY QARR/HEDIS Medical Record Review – Requests are now Available!
2/6/2024
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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.
- You will meet the incentive eligibility criteria only if the following components are all met:
- Medical records submitted to our office (via Microsoft365 sFTP, fax, mail or email) no later than February 28, 2024
- The medical records submitted are compliant for the measures requested.
Fidelis Care will reimburse you $25 for each compliant medical record that meets eligibility criteria.
For those practices who cannot utilize the above options and require on-site assistance, and have over 10 records, please contact your Provider Partnership Associate to discuss if on-site retrieval can be accommodated.
*Please note, onsite retrieval is not eligible for the incentive payment for records.
Please help us meet NCQA deadlines by submitting all requested information by 4/12/2024.