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July 2019
Reminder: naviHealth managing authorizations for MA members moving to post-acute care facilities
We notified you in a May Record article that naviHealth will be managing authorizations for Medicare Plus BlueSM PPO and BCN AdvantageSM members who are moving into skilled nursing, long-term acute care and inpatient rehabilitation facilities. The transition to naviHealth became effective for authorization requests submitted for admission dates on or after June 1, 2019, for both in-state and out-of-state cases.
The transition from acute care facilities to post-acute care facilities will be supported by naviHealth, which will access the necessary resources to help ensure a safe discharge and prevent unplanned readmissions.
Here’s some additional information to keep in mind:
- Post-acute care facilities should always check to see if an authorization is in place when they’re handling an admission for a Medicare Advantage patient. If an authorization wasn’t submitted by the acute care facility, then the post-acute care facility should submit the authorization request.
- Retrospective authorizations can be submitted electronically up to 90 days post-discharge from an acute care facility. Beyond 90 days, authorizations must be phoned in or faxed.
For more details on how to submit authorization requests, see the May Record article.
Also, we recently updated our FAQ on post-acute care services. Click here to access it.
If you missed the training, you can view recorded webinars on navihealth.com/bcbsm.
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