Medicare Advantage (MA) Auto Approval for SNF Admissions

Blue Cross and Blue Shield of Nebraska will auto-approve for the three days in a Skilled Nursing Facility (SNF) for all MA PAR providers.

Requirements:

Notification of admission

• Must be submitted within 72 hours of admission. 
• PAR providers: Submit via NaviNet to initiate authorization and enable continued stay review access   
• Out-of Network OON) / Out-of-state (OOS) Providers alternative methods: 
  • Preferred Method: If you have access to the provider portal, please use it to submit your request. 
  • Alternative Method: If you do not have portal access, you may use the Universal Prior Authorization Request Form, available on the Preauthorization page. Clear navigation buttons will guide you to the appropriate option for these exceptions. For Out-of-Network and Out-of-State Providers 

Concurrent authorization Review

• Required to certify additional days beyond the initial three. 
• 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 three days, authorization will be required on day four and after.