Posted in #Medicareadvantage, #unitedhealthcare, Training, Updates

UHC Medicare Advantage: change in post-acute care management ,04/01/21

UHC partnered up with naviHealth to manage certain post-acute care administrative processes for Medicare Advantage members in Arkansas, Kansas, Kentucky, Maryland, District of Columbia, Oklahoma, Oregon, South Carolina, Virginia, Washington and Wisconsin. This includes:

  • Prior authorization
  • Concurrent (continued stay) review and discharge planning for skilled nursing facilities (SNFs)
  • Acute inpatient rehab (AIR)
  • Long-term acute care (LTAC)

This change will take affect as of 04/01/21 and for all DOS thereafter.

The Plans that this change applies to are:

  • Medicare Advantage plans, previously managed by UnitedHealthcare
  • Dual Eligible Special Needs Plans (DSNP)
  • Chronic Special Needs Plans (CSNP)
  • The Medicare component of Fully Integrated Dual Eligible (FIDE) plan (as applicable to your state)   

Plans not included:

  • Any Medicare Advantage members included in a delegated risk agreement to provider medical groups (e.g., Optum Care Network)

Questions regarding UHC and naviHealth Partnership:

Please visit: UHC and naviHealth Partnership Launch – naviHealth

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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