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Tuesday • Posted by Provider Relations
Fidelis Care would like to remind providers of CMS correct coding guidelines to prevent billing errors and potential audits.  Fidelis Care has found instances where claims for the same service were billed multiple times using the same revenue code.  Per CMS guidelines, providers must ensure that each service charge has a distinct revenue code.   Reference Material Centers for Medicare & Medicaid Services (Chapter 1/ Subsection 120.3 - Suspect Duplicates, Page 261 and 263) - Click Here   If you have any questions, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.  
Last Week • Posted by Provider Relations
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: Fidelis Care Provider Portal and Availity Essentials Transition Encourage Patients to Get Screened for Hepatitis C Family Planning and Reproductive Healthcare Prevent Lead Poisoning The Importance of Domestic Violence Screening    Please download Fidelis Care Provider Bulletin – Volume 11, Issue 1.   To view our Provider Bulletin Library, please visit: Provider Bulletins.
2025/2/6 • Posted by Provider Relations
Fidelis Care is pleased to announce that the new Quality Care Incentives (QCI) Program is now available on Provider Access Online. Once logged in, please navigate to the File Downloads section to access the brochure.   Fidelis Care is committed to ensuring that our members have access to essential preventive services that promote overall well-being and enhance their quality of life. As a contracted provider with Fidelis Care, your role is vital in helping us achieve this commitment.   For over 25 years, Fidelis Care has provided incentive payments to participating providers for delivering routine preventive care and promoting health among members. The organization remains dedicated
2025/2/6 • Posted by Provider Relations
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. 
2025/2/6 • Posted by Provider Relations
The Fidelis Care Provider Relations Department is committed to building strong and lasting relationships with our providers and their staff.  To foster this partnership, we have assigned a Provider Relations Specialist to communicate important information and provide support to our providers. Please be sure to reference our Contact Your Designated Provider Relations Specialist web page if you do not know the name of the specialist assigned to your provider group.  To note, there are times that we adjust territory assignments to better serve our providers, so it important to periodically verify your assigned specialist. If you are unable to determine the identity
2025/1/31 • Posted by Provider Relations
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 12/10/2024.  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 medical record supplemental data by 2/1/25. 
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