Change in Texas post-acute care management

Last modified: November 8, 2021

Effective Jan. 1, 2022, naviHealth will start managing post-acute care (Medicare Part A benefit) for UnitedHealthcare® Medicare Advantage members in Austin, Brazoria, Brazos, Chambers, Fort Bend, Galveston, Grimes, Hardin, Harris, Jackson, Jasper, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, Waller, Washington and Wharton counties.

This includes prior authorization, concurrent (continued stay) review and discharge planning for members transitioning to and receiving skilled care in:

  • Skilled nursing facilities (SNFs)
  • Acute inpatient rehab (AIR)
  • Long-term acute care (LTAC) 

Plans included: 

  • Medicare Advantage plans managed by WellMed; naviHealth replaces
    WellMed’s post-acute care management service 
  • Dual Special Needs Plans (DSNP)
  • Chronic Special Needs Plans (CSNP)

Plans not included:

  • UnitedHealthcare Institutional Special Needs Plans (ISNP)
  • UnitedHealthcare Institutional-Equivalent Special Needs Plans (IE-SNP)
  • UnitedHealthcare commercial plans
  • UnitedHealthcare Community Plans (Medicaid-only plans)
  • Long-Term Support Services (LTSS)

What happens next

You'll receive an email invitation to attend a provider education session. Attending the session will help ensure a smooth transition for you, your teams and our members.

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.

Questions? Contact WellMed at TexasSpecialists@wellmed.net.

1-21-03948-M&R-News_10282021