Medicare Wellcare by Fidelis Care Oncology Medications and Supportive Agents Review Requirements
Requires review by Evolent (formerly New Century Health/NCH) for participating providers before oncology medications and supportive agents are dispensed at a pharmacy or administered in outpatient/ambulatory settings for members of all ages; includes lists of HCPCS/CPT/J-codes and pharmacy-only NDC/J-code groupings requiring review and preferred biosimilars. Out-of-scope categories are listed.
Effective 11/1/2023 for Wellcare by Fidelis Care - list of HCPCS/J-codes and pharmacy mappings requiring review.
Fax number for non-participating providers updated to 1-844-235-5090 effective 10/1/2023.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.