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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

Fidelis Care would like to make providers aware of a scheduled outage of the Fidelis Care Provider Portal.  Beginning at 10PM EST Friday, July 19, through 4PM EST Saturday, July 20, the Provider Portal will be unavailable due to an upgrade of supporting systems. In addition, our Fidelis Care Interactive Voice Response (IVR) and Real-Time Eligibility Calls (X12 270/271) accessed through our Call Center will also be unavailable. For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist. Thank

Fidelis Care would like to make providers aware of a scheduled outage of the Fidelis Care Provider Portal.  Beginning at 10PM EST Friday, July 19, through 4PM EST Saturday, July 20, the Provider Portal will be unavailable due to an upgrade of supporting systems. In addition, our Fidelis Care Interactive Voice Response (IVR) and Real-Time Eligibility Calls (X12 270/271) accessed through our Call Center will also be unavailable. For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Relations Specialist. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist. Thank

Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community. Articles in this issue: New York State School Vaccinations and Well Child Visits 2023 Survey Indicates Improved Provider Satisfaction The Importance of Regular Dental Visits for All Ages Fidelis Care Partners with Pomelo Care Help Stop the Spread of Tuberculosis   Please download Fidelis Care Provider Bulletin – Volume 10, Issue 3.   To view our Provider Bulletin Library, please visit: Provider Bulletins.