Effective Jan. 1, 2023, naviHealth will no longer manage the Medicare component of Highly Integrated Dual Eligible (HIDE) or Fully Integrated Dual Eligible (FIDE-AIP) Medicare Advantage plans in the District of Columbia, New Jersey, Tennessee and Virginia. Instead, UnitedHealthcare will manage these plans.
This includes prior authorization and concurrent review, including discharge planning, for all post-acute levels of care:
Skilled nursing facilities (SNFs)
Acute inpatient rehab (AIR)
Long-term acute care (LTAC)
Plans affected by this change include:
Tennessee Dual Complete® ONE (FIDE)
District of Columbia Dual Choice® (HIDE and FIDE)
New Jersey Dual Complete® ONE (FIDE)
Virginia Dual Complete® ONE (FIDE)
Any other state plans not specifically included above are not affected.
For questions about this transition, please reach out to your assigned naviHealth provider relations manager in your state.