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February 2022

Medicare Advantage post‑acute care: New 30‑day limit on documents in naviHealth portal

Starting Feb. 11, 2022, documents for Medicare Plus Blue℠ and BCN Advantage℠ members will be available within naviHealth’s nH Access™ portal** for only 30 days from the date they’re posted.

If you need access to a document after it’s been removed from nH Access, contact your naviHealth care coordinator.

If you have questions about this change, contact your local naviHealth provider relations manager. If you aren’t sure who your naviHealth provider relations manager is, email umproviderconcerns@bcbsm.com.

About naviHealth

naviHealth Inc. is an independent company that manages authorizations for post-acute care services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans. naviHealth is committed to improving the post-acute care experience for our Medicare Advantage members. As part of this commitment, naviHealth provides access to patient information and documentation during the prior authorization process by making documents available through nH Access.

As a reminder, naviHealth:

  • Authorizes patient-driven payment model levels during the patient's skilled nursing facility stay (from preservice through discharge).
  • Authorizes patient-driven payment model levels based on medical-necessity review and their proprietary naviHealth Predict functional assessment.
  • Works with skilled nursing facilities to ensure billers submit proper patient-driven payment model levels for reimbursement.

For more information, see Post-acute care services: Frequently asked questions for providers.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.