Change in post-acute care management

Last modified: March 9, 2021

Effective April 1, 2021, naviHealth will start managing 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)

Plans included: 

  • 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

To learn more about naviHealth and the UnitedHealthcare partnership visit navihealth.com/united-provider-info. Please bookmark this site and check back frequently. Ongoing updates will be posted.