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April 2019

Transitions to post-acute care facilities for Medicare Advantage patients to be managed by naviHealth starting in June

Authorizations for Blue Cross Medicare Plus BlueSM PPO and BCN AdvantageSM members who require a transfer from acute inpatient hospitals to skilled nursing, long-term acute care or inpatient rehabilitation facilities will be managed by naviHealth, effective June 1, 2019. naviHealth, an independent company that handles care transitions, will be reviewing both in- and out-of-state post-acute care cases.

Blue Cross and BCN are transitioning to naviHealth as part of an effort to standardize the handling of authorizations for post-acute care for Medicare Advantage members. The change is also expected to provide a more coordinated, patient-focused approach that’s aimed at improving the patient’s physical function and reducing the likelihood of readmission to an acute care setting.

Join us to learn more
Training sessions have been scheduled and will include information regarding the naviHealth clinical model and provider portal. Administrators, case managers, rehabilitation directors, nursing directors are others involved in post-acute patient care are encouraged to attend a webinar. Even if you’re already familiar with naviHealth, we hope you’ll attend to learn how naviHealth will work with Blue Cross Medicare Plus Blue PPO and BCN Advantage patients.

Click on the date and time below to register for your preferred webinar:

Acute care hospitals
Skilled nursing facilities
Inpatient rehabilitation facilities and long‑term acute care hospitals

Hold the date
Skilled nursing facilities will also be invited to attend in-person forums the week of May 13 in Grand Rapids, Saginaw, Southfield and Traverse City. Registration information will be available in the May issue of The Record.

We’ll bring you additional information about this change in future issues of The Record and BCN Provider News.