naviHealth webinars about SNF PDPM payment methodology

For Medicare Advantage skilled nursing facility admissions with service dates on or after Oct. 1, 2019, naviHealth will authorize Patient-Driven Payment Model levels during the patient's stay (from preservice through discharge) to align with the Centers for Medicare & Medicaid payment methodology. We first communicated this change in late July.

To learn how naviHealth has been preparing for the changes to payment methodology with PDPM, register for and attend one of their live webinars, which are scheduled for September 3, 4 and 5.

During the webinars, naviHealth will cover the following:

• The naviHealth clinical model under PDPM
• The enhancements that are planned for the nH Predict|Outcome reports and nH Predict|Pulse
• The process for PDPM level assignment including:
  • The additional clinical information necessary to process a request
  • How to request a level reconsideration
  • A review of claims processing

You can view additional information on The Patient Driven Payment Model (PDPM) - Information and Resources for Provider Partners page of the naviHealth website.*

As a reminder, naviHealth manages authorization requests for Medicare Plus Blue^SM PPO and BCN Advantage^SM members admitted to post-acute care on or after June 1, 2019. For details, see the Post-acute care services: Frequently asked questions by providers document.

*Blue Cross Blue Shield of Michigan and Blue Care Network don't own or control this website.

Posted: August 2019
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network