Publication Date: 

Effective immediately, naviHealth is implementing a more streamlined approach to the pre-service authorization process for members requiring care in a skilled nursing facility.

Key Points

  • This process is effective for carriers that reinstated authorization policies on or after May 26, 2020.
  • The updated process:
    • Requires less documentation and fewer requests for clinical information
    • Introduces a “Rapid Review” to quickly transition patients with certain conditions
    • Discontinues the assignment of a preliminary CMG during pre-service authorization
  • You can access detailed information about this program here, or click here to review the June 10th webinar presentation.

Please contact Christopher Weston at 336-473-3848.