Medicare Advantage (MA) Auto Approval for SNF Admissions

Effective Jan. 1, 2025, Blue Cross and Blue Shield of Nebraska will auto-approve for the first seven days in a Skilled Nursing Facility (SNF) for all MA PAR providers.

Requirements:

Notification of admission

• Must be submitted within 72 hours of admission.
• Preferred method: Submit via NaviNet to initiate authorization and enable continued stay review access.
• Alternative methods:
  • Fax: 1-866-422-5120
  • Phone: 1-877-399-1671

Concurrent authorization Review

• Required to certify additional days beyond the initial seven.
• Ensures timely issuance of the Notice of Medicare Non-Coverage to both the facility and the member.
• If faxing medical records, please send by noon on the due date to maintain review timeliness.

Providers who do not follow the outlined requirements will no longer be eligible for auto-approval.

If a SNF admission goes beyond seven days, authorization will be required on day 8 and after.