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Fidelis Care обслуживает более 1,7 миллиона детей и взрослых всех возрастов, что делает нас одним из крупнейших планов медицинского страхования в штате Нью-Йорк. Мы были основаны на убеждении, что все жители Нью-Йорка должны иметь доступ к качественному и доступному медицинскому страхованию, и наша миссия помогать другим лежит в основе всего, что мы делаем. 

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Last Week • Posted by Provider Relations • in Provider News
Mental health concerns are increasingly being addressed in primary care settings, making it more important than ever for providers to have access to practical tools, expert guidance, and continuing education. That's where Project TEACH can help. Project TEACH (Training and Education for the Advancement of Children's Health) is a New York State-funded program that supports primary care clinicians caring for children, adolescents, and perinatal patients with behavioral health needs. Through education, psychiatric consultation, and referral resources, Project TEACH helps providers build confidence in identifying, evaluating, and managing common mental health conditions within their practices. This fall, Project TEACH is offering a series
Last Week • Posted by Provider Relations • in Provider News, Provider Quality
Your practice is already doing the work: screenings, chronic condition management, follow-up care, and documentation. The key is making sure that work is captured accurately, so it reflects the quality of care your team provides. The Fidelis Care Clinical Quality Optimization Team partners with providers and office staff to strengthen documentation, improve workflows, close care gaps, and support performance in HEDIS®, QARR, Medicare Star Ratings, and other quality measures. Why Providers Partner with Us Support is tailored to each practice and may include: Workflow, EHR, documentation, and coding optimization Care gap closure and quality measure strategies Provider and staff education based on practice
23.09.2026 • Posted by Provider Relations • in Provider News, Provider Quality
Fidelis Care will host three Provider Office Hours in October 2026. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours October 2026 Topic: Fidelis Care – Tools and Resources Overview When:  Thursday, October 8th – 12PM – 1PM EST Click here to register*   Topic: Fidelis Care and Wellcare Quality Programs When:  Wednesday, October 21st – 10:30AM – 11:30AM EST Click here to register*
04.09.2026 • Posted by Provider Relations • in Provider News
To support accurate and timely claims processing, providers are reminded not to submit a corrected claim until the original claim has completed processing and reached a finalized status. When a corrected claim is submitted for a claim that has not yet finalized, the submission will be rejected with code 6U – Unfinalized claim; replacement cannot be accepted. This rejection is intended to prevent duplicate or conflicting claim activity while the original claim is still under review in process. What Providers Need to Know Wait for the original claim to finalize before submitting a corrected claim. Corrected claims submitted before the original claim
03.09.2026 • Posted by Provider Relations • in Provider News
As you may be aware, Section 12006 of the 21st Century Cures Act, along with CMS guidance, required states to implement Electronic Visit Verification (EVV) for Personal Care Services by January 1, 2021, and for Home Health Care Services by January 1, 2023. As of 2026, EVV requirements are fully implemented, requiring applicable services to be electronically verified and documented, including the member receiving care, caregiver, service location, date, and type of service provided.   Next Steps To ensure EVV data is accurately captured for providers delivering in-scope EVV services, Fidelis Care will require all providers — including existing EDI and Enterprise (ENT) providers — to submit
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