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May 2019

Additional Medicare Advantage post-acute care training dates set

As you read in the April Record, authorizations for Medicare Plus BlueSM PPO and BCN AdvantageSM members who are moving into skilled nursing, long-term acute care and inpatient rehabilitation facilities will be managed by naviHealth starting in June. We have a complete training schedule, detailed later in this article, to assist you with the transition.

The transition to naviHealth is effective for authorization requests submitted for admission dates on or after June 1, 2019, for both in-state and out-of-state cases. It includes members moving from acute care facilities or from another site of care.

As part of our move to naviHealth, we’re working to standardize the management of authorizations for post-acute care for Medicare Advantage members. In addition, we hope to improve the member experiences by offering a more coordinated, patient-focused approach — one that’s aimed at improving the member’s outcomes and reducing the likelihood of readmissions to an acute care setting.

What’s changing
For Medicare Plus Blue and BCN Advantage members admitted on or after June 1, 2019, you’ll submit authorization requests for skilled nursing, long-term acute care and inpatient rehabilitation to naviHealth.

You should submit these requests through the naviHealth provider portal. To access the naviHealth portal, follow these steps:

  1. Visit bcbsm.com/providers.
  2. Log in to Provider Secured Services.
  3. Click on Medicare Advantage Post-Acute Care Authorization on the Provider Secured Services homepage.
  4. Enter your NPI.
  5. Click on Go.

The naviHealth provider portal screen will open and you can enter your request. If you’re unable to access the naviHealth provider portal through Provider Secured Services, call the Blue Cross Web Support Help Desk at 1-877-258-3932 for assistance.

There are other ways to submit these authorization requests to naviHealth:

  • Through the naviHealth provider portal at access.navihealth.com.
    Note: This option will not be available until June 1, 2019. You must first register with naviHealth for access to its portal. We’ll let you know how to do that in the training webinars.
  • By phone: 1-855-851-0843
  • By fax:
    • Fax new authorization requests to 1-844-899-3730.
    • Fax continued stay requests to 1-844-736-2980.
    • Fax discharges to 1-844-729-2591.
  • By email (for discharges only): mid-west_discharge_info@navihealth.com

You can also submit these requests through Allscripts. Follow your current process for submitting to Allscripts.

You can use any of the above-mentioned methods to submit authorization requests for both in-state and out-of-state members covered by Medicare Plus Blue PPO and BCN Advantage plans.

Refer to the Post-acute care services: Frequently asked questions for providers document for more detailed information.

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, discharge planners, rehabilitation directors, nursing directors and others involved in post-acute patient care are encouraged to attend a webinar. Even if you are already familiar with naviHealth, we hope you’ll attend to learn how naviHealth will work with your Medicare Plus Blue PPO and BCN Advantage patients.

See the following table for the webinar dates and times. Click here to register.

Acute care hospitals
  • Tuesday, May 21, 8 to 9:30 a.m.
  • Wednesday, May 22, 11:30 a.m. to 1 p.m.
  • Wednesday, May 29, 8 to 9:30 a.m.
  • Wednesday, June 5, 8 to 9:30 a.m.
Skilled nursing facilities
  • Tuesday, May 21, 11:30 a.m. to 1:30 p.m.
  • Thursday, May 23, 11:30 a.m. to 1:30 p.m.
  • Wednesday, May 29, 11:30 a.m. to 1:30 p.m.
  • Wednesday, June 5, 11:30 a.m. to 1:30 p.m.
Inpatient rehabilitation facilities and long-term acute care hospitals
  • Thursday, May 23, 8 to 9:30 a.m.
  • Thursday, May 30, 11:30 a.m. to 1 p.m.
  • Thursday, June 6, 11:30 a.m. to 1 p.m.

Note: In the April Record, we provided a separate registration link for each webinar. You can register using those links, but we encourage you to click here to find all the registration information in one location.

Skilled nursing facility in-person forums
Skilled nursing facilities are invited to attend in-person forums the week of May 13 in Traverse City, Grand Rapids, Saginaw and Southfield. For locations and to register, click here.

Traverse City
  • Monday, May 13, 2-4 p.m.
Grand Rapids
  • Tuesday, May 14, 9-11 a.m.
  • Tuesday, May 14, 1-3 p.m.
Saginaw
  • Wednesday, May 15, 9-11 a.m.
  • Wednesday, May 15, 1-3 p.m.
Southfield
  • Thursday, May 16, 9-11 a.m.
  • Friday, May 17, 9-11 a.m.