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