We've resolved issues with processing SNF claims for Medicare Advantage members
This is an update to a message originally posted on Nov. 25, 2019.
We updated our systems to resolve the issues we were experiencing with processing some skilled nursing facility claims for Medicare Plus BlueSM PPO and BCN AdvantageSM members.
On Dec. 8, 2019, we resumed regular processing of these SNF claims, and we began processing any SNF claims we'd been holding.
We previously notified you of the following:
We apologize for any inconvenience.
As a reminder, naviHealth authorizes PDPM levels during the patient's stay (from preservice through discharge) for dates of service on or after Oct. 1, 2019, to align with CMS payment methodology. naviHealth works with SNFs to ensure the biller submits the appropriate PDPM level for reimbursement.
For more information, see the Post-acute care services: Frequently asked questions by providers document.
Posted: December 2019
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network