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Fidelis Care would like to notify providers that the MCG Cite Guideline Transparency Tool was upgraded to the 29th edition effective Saturday, April 26, 2025. Providers can access this tool through the Fidelis Care Provider Portal. Highlights of the changes in the 29th edition of the MCG care guidelines include: Five new observation care guidelines in MCG Inpatient & Surgical Care to support the use of observation care for specific diagnoses. In addition, a new calculator for mean arterial pressure (MAP) was added to the content (where applicable). A new “Gene and Cellular Therapy” section containing guidelines for cutting-edge treatments was added

Annual cultural competency training for participating providers is required by the New York State Department of Health.  At this time, The New York State DOH will only accept the approved training offered by the United States Department of Health and Human Services (HHS), Office of Minority Health education program, Think Cultural Health, to fulfill the requirement for provider annual cultural competency training.*   Once the cultural competency training has been completed, providers need to verify completion of the program by emailing the Cultural Competency Attestation Form to: CulturalCompetencyTrainingAttestation@fideliscare.org.   The required Cultural Competency Training needs to be completed annually by December 31st. Providers that completed

Effective May 1, 2025, the provision of School-Based Health Center (SBHC) and SBHC-Dental (SBHC-D) services will be incorporated into the Mainstream Medicaid Managed Care (MMC) and HIV Special Needs Plan (HIV SNP) benefit package. Therefore, Fidelis Care will be responsible for reimbursing SBHC operators for SBHC services provided to Fidelis Care members. The goal of the transition is to maintain access to these critical SBHC and SBHC-D services while integrating the services into the larger health care delivery system. It is anticipated that the integration of SBHC and SBHC-D services within the existing managed care framework, and coordination of services with

In an effort to streamline provider demographic changes and provider termination requests, Fidelis Care has created two new electronic forms for providers to use.  Please use these forms to submit changes under a singular TIN. In order to expedite the request, all fields on the forms are required. If not complete, the request will be delayed. Forms available on fideliscare.org: Provider Demographic Change Request Form   Provider Termination Request Form   Once completed, the forms can be submitted electronically to SMProviderAttestationUpdates@fideliscare.org. In the subject line of the email, please enter Demographic Change/Termination Request for "Your Provider/Group Name" in "Your County" (i.e. Demographic Change Request

Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. The NYSDOH requires that certain Access and Availability Standards be met by PCPs, OB/GYNs, specialists, and behavioral health providers where applicable. Click here to view the full list of standards, including situations and timeframes.   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here. 

Fidelis Care is pleased to announce that providers will soon have access to correct and resubmit a paid or denied claim, and view and reconcile remittances through their Availity Essentials account.   On April 21, Fidelis Care providers will have the following new functionality available on Availity Essentials. Claim Corrections - Correct and resubmit a paid or denied claim from the Claim Status Response page. Ask your Availity Essentials Administrator to assign you the Claim Status role if this task is appropriate for your role.   Remittance Viewer - Locate remittances with ease using the extensive search and filter options. You can