Добро пожаловать, поставщики медицинских услуг штата Нью-Йорк!

As part of New York’s Medicaid Redesign Team (MRT) initiative, the NY 1115 Waiver introduced the Social Care Networks (SCN) Program, a transformative model focused on integrating social care into healthcare delivery. The SCN program encourages partnerships across health and social services to address Medicaid members' diverse needs, such as food insecurity, housing instability, and lack of transportation. Many of these services may become reimbursable to a member under the provision of this waiver.   How the SCN Program Works: Eligible Medicaid, MAP, MLTC, and HARP Members have access to a wide range of free services through the local Social Care Network (SCN),

Fidelis Care would like to inform providers of a postpartum visit incentive being offered through the New York State (NYS) Medicaid program. This program will provide an additional payment to the current NYS Medicaid reimbursement for comprehensive, timely postpartum visits provided to Medicaid Managed Care (MMC)/Fidelis Care Medicaid members. The incentive payment will apply to postpartum visits for deliveries that occurred from July 1, 2024, through March 31, 2025. Providers who delivered a person-centered comprehensive postpartum visit as outlined by the American College of Obstetricians and Gynecologists clinical guidelines, including a postpartum depression screen, to Fidelis Care members within 12 weeks

ЛОНГ-АЙЛЕНД-СИТИ, штат Нью-Йорк (10 июня 2025 г.). Fidelis Care, действующий в масштабах всего штата план медицинского страхования с более чем 2,4 млн участников в штате Нью-Йорк и компания Centene Corporation, открыли прием заявок на участие в программе грантов для матерей на 2025 год. Гранты, доступные для поставщиков медицинских услуг и общественных организаций в Нью-Йорке, направлены на финансирование программ, поддерживающих инновационные стратегии в области послеродового ухода и психического здоровья матерей. Заявление можно скачать, перейдя по ссылке: fideliscare.org/maternal-grant. Крайний срок подачи заявок — 8 июля 2025 г., 17:00.

Fidelis Care would like to remind providers of the appropriate coding modifiers to use when billing for a surgical or diagnostic procedure that was discontinued or stopped prior to completion for both facilities and physicians.    Modifiers 73/74 are specifically used by facilities, to indicate that a procedure was discontinued or stopped prior to completion.  Coinciding with these facility modifiers, physicians should bill modifiers 52/53, which also indicates that a procedure was discontinued or cancelled.  If a procedure has been discontinued, both facility and physician claim submissions should reflect the discontinuation, by using the appropriate modifier codes below.   Facility Modifier Codes: Modifier 73:

The following section of the Fidelis Care authorization grids have been updated effective August 1, 2025.   The following code has been added on the Medicare, Medicaid, Essential Plan, and Metal-Level Products Authorization Grids and require prior authorization: III.       Outpatient surgery: P. CAR-T Therapy: Q2058   Visit:  Authorization Grids

Fidelis Care will host three Provider Office Hours in July 2025. During the webinar, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – July 2025   Topic: Fidelis Care – Back to Basics When:  Thursday, July 10th – 9AM – 10AM EST Click here to register*   Topic: Claims and COB Overview When:  Thursday, July 24th – 2PM – 3PM EST Click here to