Https //Providers.fideliscare.org/Passcode Content: Fidelis Care’s quality and affordable health insurance policies cover over 2.3 million children and adults of all ages and stages of life. Other programs, including Child Health Plus, the Essential Plan, the Health and Recovery Plan, the Managed Long Term Care Program, Medicare Advantage, Dual Advantage, and Medicaid Advantage Plus, provide coverage in addition to Medicaid Managed Care and Qualified Health Plans.
When our Medicare Advantage and Dual Advantage plans are renamed in 2022, they will be called Wellcare By Fidelis Care. Albany, Buffalo, Syracuse, Rochester, and New York City all have regional offices. More than 20 Fidelis Care community offices are established throughout the state to help service members and individuals who have questions about health insurance. Fidelis Care’s mission is community involvement at all levels, from inner-city neighborhoods to rural villages.
Fidelis Care works with a variety of organizations to assist those in need, including schools, churches, food banks, and other community organizations. Fidelisaurus is Fidelis Care’s official mascot, and he promotes health insurance for children and families, as well as regular checkups, physical activity, and a balanced diet. The Fidelisaurus enjoys collaborating with his Fidelis Care companions to deliver positive health and well-being messages in the communities we serve.
The following is a basic overview of who we are:
Centene is committed to helping people live healthier lives. We provide high-quality health care, as well as innovative initiatives and a wide range of health solutions to families and people.
Both the public and private sectors are involved
Centene has administered government-sponsored healthcare initiatives since the 1980s, saving public money while improving patient health outcomes. State and local governments, healthcare professionals, patients, their families, and a variety of other healthcare and corporate institutions are among the numerous groups we assist. Collaboration is critical for removing barriers to health and ensuring that everyone in each state, individual, and family has access to the best care possible.
Methods of Input/Output/Processing
The following components make up our Quality Assurance System: Because previous performance is taken into account, the care and services provided to members are improved. Maintains adherence to all relevant state, federal, and municipal regulations. Helps healthcare providers to provide better care to patients Credentials for providers are issued and renewed here. The Medical Management Division is responsible for healthcare services such as Medical Management and Case Management (MMD).
Clinical as well as preventative care
Fidelis Care collaborates together with CMS and the New York State Department of Health to develop and implement strategies to improve the quality of health care offered. Quality reporting includes preventive care for children and adults, maternity care, long-term care, chronic illness management, including diabetes and HIV/AIDS, behavioral health care, and assistance with daily living for the elderly. In 2018, 93 percent of the 215 quality measures reported by Fidelis Care (Medicaid) matched or exceeded the state average.
As part of its efforts to assure high-quality clinical and preventative care, Fidelis Care performs member outreach and education. In the 2018 member mailings, members were reminded of the need of getting a flu vaccine, recommended testing for diabetes, and reminders for new parents of important well-child appointments and childhood immunizations. Here are a few examples of the Plan’s outreach efforts. It’s all about becoming a part of our members’ happiness for us.
Designed help individual manage pharmaceutical regimen
According to Fidelis Care’s Medication Therapy Management Program, patients are protected against receiving incorrect prescriptions. The initiative works with health care practitioners to identify patients who may be at risk, based on recognized clinical recommendations. Within 60 days of receiving their enrollment notification, eligible members are provided a Comprehensive Medication Review (CMR). Fidelis Care increased the CMR completion rate from 78.1 percent in 2017 to 84.7 percent in 2018, exceeding the Plan’s 2018 objective of 80 percent.
Case Management
Fidelis Care members have access to Case Managers who provide individualized care for clients with chronic illnesses or severe medical needs. With the help of a Case Manager, a member’s care and services can be coordinated. Case management programs for Sickle Cell Disease and Hemophilia were offered in 2018 because they were deemed helpful by our members. Members learn how to take control of their health, how to navigate the health-care maze, and where to access services in their communities.
Members of the organization’s satisfaction
Fidelis Care conducts surveys on a regular basis to ensure that our members are satisfied with the care and services they get. The replies we obtain from these surveys benefit our health plan significantly, and we use that information to make required improvements. The Plan’s 2017 member satisfaction surveys informed many of its 2018 enhancement efforts. The Fidelis Care website was redesigned to improve the online payments tool and ease of site navigation, provider education to encourage best practices around member engagement,
Members being mailed information about Plan benefits and services, mandatory training for all Fidelis Care employees on the role each employee plays in creating positive member experiences, and member mailings are just a few examples of improvements. Fidelis Care tries to address our members’ requirements in their preferred language. We can gladly assist a member who requests material in a language other than English.
Deep Packet Inspection Tools That Detect Gaps More Effectively
Content access is required for accurate threat, malware, command, and control, and data leakage detection on any network. Because the information may be disguised behind several levels of encoding, contained in office documents and PDFs, conveyed over email, or as part of the payload of a web page, the term “content” does not apply to a single packet in this context, but rather to the entire network session as a whole.
The most common type of content inspection, Deep Packet Inspection, looks at individual packets rather than the code at the lowest level. Fidelis Cybersecurity developed and patented its Deep Session Inspection® (DSI) solution to get around these limitations. By collecting and interpreting information in context, content-focused security concerns can be detected along the kill chain, from the initial attack through data loss. Deep Session Inspection is explained in this article, including how it works, what it can observe, and what it can accomplish for security teams.
The No Surprises Act: How to Get There Using Provider Directories
HealthShare providers’ directory: It’s been tough for the healthcare industry to ensure that patients get accurate information about doctors’ in-network status and if they’re accepting new patients. Additional standards for provider directories were set by the No Surprises Act (part of the Consolidated Appropriations Act, 2021), with rulemaking to implement these statutory provisions due later this year.
Panelists:
- Lynda Rowe is InterSystems’ Senior Advisor for Value-based Markets.
- She is the deputy chief health information officer and director of the Centers for Medicare & Medicaid Services.
- Government Relations Manager for the American Heart Association, Joshua Roll
When it comes to Medicaid Managed Care Procurement,
Mike DeWine, Ohio’s governor, ordered ODM in January 2019 to ensure that Ohioans get the best value for the quality treatment they received. As a result, we developed a new, innovative approach to Medicaid in Ohio, one that prioritizes individuals over the bottom line of managed care. The Centers for Medicare and Medicaid Services (CMS) approved Ohio’s Medicaid program in 2005.
