BCBSND offers Waiver of Precertification of Authorization for Post-Acute/Alternative Care

Doctor typing information on Laptop in Hospital office focus on Stethoscope

In response to the COVID-19 Crisis, BCBSND offers solutions to care challenges

FARGO, N.D. – Blue Cross Blue Shield of North Dakota (BCBSND) will temporarily waive the precertification process for all In-State Post-Acute/Alternate Care Service requests when transferring from acute care hospitals beginning November 12, 2020 through December 31, 2020. The decision to extend this emergency waiver was made in consultation and with the approval of the North Dakota Insurance Department (NDID).  

Admission notification for the transfer of patients to these services must be made to BCBSND, preferably via Availity, our Provider Portal. Notification can also be made via fax at 701-277-2971. Concurrent review of these cases must be completed by day seven of the patient transfer. At that time, clinical documentation will be required for continued approval.

Post-Acute/Alternate Services covered under this temporary change include:

  • Skilled Nursing Facilities
  • Long Term Acute Care Facilities
  • Home Health Care
  • Hospice Care
  • In-patient Rehab Facilities
  • Transitional Care Units

“Our team understands the serious demands that have been placed on North Dakota healthcare workers due to the COVID-19 pandemic,” said Dr. Greg Glasner, BCBSND Chief Medical Officer. “We’re working with providers to find solutions for North Dakotans and the healthcare workers that care for them. We’re here to help alleviate critical bed capacity concerns for those who need immediate care.”

To date, BCBSND members have incurred $77,970,000 in claims related to COVID-19.

Precertification will continue to be required for Post-Acute/Alternate Care services requested for Out-of-State services.

About Blue Cross Blue Shield of North Dakota

BCBSND (www.BCBSND.com) was founded in 1940 with the mission to provide members with affordable access to health care across the state. As a member-owned, not-for-profit independent licensee of the Blue Cross and Blue Shield Association (BCBSA), BCBSND is committed to transforming care and health across the state to improve outcomes, lower cost trends and make it easier to shop, buy and use health care coverage. Members have access to unmatched local service and to a comprehensive network of health care providers across the state, the nation and in 200 countries.