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Fidelis Care would like to remind our providers of a claim denial reason code that is used when COB claim resubmission requirements are not met.  EX CODE:  50M Short Description:  Claim resubmission requirements not met Long Description:  COB resubmission requirements not met - missing resubmission code and/or reconsideration form The denial reason will occur when providers do not indicate the appropriate resubmission code or do not include the reconsideration form. This denial reason code is specific to COB claims that have been resubmitted to Fidelis Care.   In order to avoid this denial, please follow the instructions below for claim corrections and reconsiderations:  Electronic Submission of Corrected

September is National Substance Use Prevention Month, a time to raise awareness, reduce stigma, and promote prevention, harm reduction, treatment, and recovery resources for individuals and families affected by substance use disorders. Substance use disorders impact millions of people each year, affecting individuals, families, workplaces, and communities. Prevention begins with education, early intervention, and ensuring that people know help is available when they need it. By encouraging open conversations and increasing access to care, we can help prevent substance misuse and support individuals on their recovery journey.   Harm Reduction Saves Lives Harm reduction is an evidence-based approach that focuses on reducing the negative

The HEDIS® behavioral health F-series measures focus on timely transitions of care following behavioral health and substance use-related hospitalizations or emergency department visits. These measures highlight the importance of connecting members to follow-up care within 7 days to support recovery and improve outcomes. They include: •           Follow-Up After Hospitalization for Mental Illness (FUH) •           Follow-Up After Emergency Department Visit for Mental Illness (FUM) •           Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) •           Follow-Up After Emergency Department Visit for Substance Use (FUA) The days immediately following discharge are critical. Without timely follow-up, members may experience worsening symptoms, challenges with treatment adherence, or an increased risk

Depression is one of the most common behavioral health conditions affecting adolescents and adults, yet many individuals remain undiagnosed and untreated. The Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) measure highlights the importance of screening members for depression and ensuring appropriate follow-up when a screening result is positive. Primary Care Providers are often the first point of contact for members and play a critical role in identifying behavioral health concerns early. Providers are encouraged to incorporate depression screening into every annual wellness visit, particularly for adolescents and young adults, as early identification can lead to timely intervention and improved

Women's preventive screenings are essential for detecting health conditions early, improving outcomes, and supporting lifelong health. Whether discussing breast cancer screening, cervical cancer screening, colorectal cancer screening, or chlamydia screening, every patient encounter provides an opportunity to review preventive care needs and close gaps in care. One area of ongoing concern is chlamydia screening, where screening rates continue to present challenges nationally and across health plans. Because chlamydia is often asymptomatic, many women may not realize they are at risk or understand the importance of routine screening. Providers can help address this gap by normalizing conversations about sexual health and incorporating