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Payer Contract and Discharge Planning Updates

Anthem

Anthem (Commercial Plan) distributed an update on policy in response to COVID-19 aspects. Within this update, it speaks to the fact Anthem is waiving the pre-cert requirement for skilled nursing facilities (SNF) from a hospital setting. Care Management can use this information while they work with area Skilled Nursing Facilities. We will be sending notification to Skilled Nursing Facilities shortly to ensure they have been made aware. Here is the exact verbiage of that section:  

Is Anthem making any additional changes to its prior authorization requirements to assist providers during the COVID-19 national emergency? 

Anthem is committed to working with and supporting providers. As of March 16, Anthem is removing prior authorization requirements for SNF for the next 90 days to assist hospitals in managing possible capacity issues. SNF providers should continue admission notification to Anthem in an effort to verify eligibility and benefits for all members prior to rendering services and to assist with ensuring timely payments. Click here to access this information. 

UHC

UHC Commercial has also waived pre-cert requirements for SNF. Click here to access this information.  

To keep information regarding payer updates related to COVID-19 response streamlined for easy communication, the attached grid has been developed. We will continue to distribute as updates occur.  

Latest Payer Guidelines Updated 3/25/2020

UHC Links 
COVID-19 
Support Resources 
FAQ 
Telehealth Policies 
Prior Auth Updates 

Anthem Link 

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March 25, 2020