You can request authorization using the naviHealth nH Access – naviHealth online portal – and you will receive an electronic notification of your request status via the portal. Portal requests are the preferred method for authorization requests, but if needed, naviHealth can accept requests by faxing the standardized cover sheet and documentation to 888-815-1808.
Impacted plans This new process will apply to members enrolled in Medicare Advantage plans, including D-SNP members, who reside and receive services in Colorado, Kentucky and Tennessee. We’ll perform continuation of care reviews for Home Health Agencies (HHAs).
Plans out of scope for this new requirement include:
UnitedHealthcare commercial plan
United Healthcare Community Plan (Medicaid)
Any delegated provider medical groups
Institutional Special Needs Plans (I-SNP)
Long-Term Support Services Fully Integrated Dual Eligible Plans
For states and UnitedHealthcare Medicare Advantage and D-SNP not mentioned, current existing requirements and processes remain unchanged.
What you need to know UnitedHealthcare will delegate the initial authorization and concurrent review processes for home health services to naviHealth. naviHealth will utilize portal technology and automated decision support tools to help manage the processes that your agency will use to submit authorization requests. We’ll use the criteria in our Medicare Advantage Prior Authorization Requirements to facilitate our home health authorizations and concurrent reviews.