Currently naviHealth, Inc handles Utilization and Case/Care Management for post-acute services—including Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), and Home Health—for MVP Medicare Advantage, DualAccess, and DualAccess Complete Members.

However, MVP and naviHealth, Inc will end their contract as of Dec 31st 2025.

Starting on Jan 1,2025 MVP will process these requests in house.

More information to come in Nov 2025.

Find this type of content useful? Follow my blog for more!

• FidelisCare: pre- pay claim review for COB – third party payers
• Tobacco screening services- proper coding and billing- UPMC Community Behavioral Health Org:UPMC Community Behavioral Health Org
• Are you using the proper Anesthesia codes for fascial plane blocks?
• HighMark BCBS: reimbursement for massage therapy services
• NYS Medicaid: reduce denials MAT/ OASAS services-