NextBlue of North Dakota Medicare Advantage Important Message

NextBlue values the care delivered by our Post Acute Care (PAC) provider network. We are evaluating ways to create administrative efficiencies for facilities and are excited to introduce an adjustment to our prior authorization process.

Beginning October 1, 2024, NextBlue will be transitioning from the seven-day review process for Skilled Nursing Facility (SNF), Long Term Acute Care (LTAC), Inpatient Rehab and Swing Bed services. We will be converting to a 21-day cycle for continued stay reviews.

On this effective date, plan on the following:

• Submit the initial authorization request, in the same manner as before. We are able to accept authorizations via portal, phone or fax. At the time of the authorization, indicate the expected length of stay.
• If a member is planned to stay 21 days or longer, submit a continued stay authorization for days 21 and later.

To help support transitions of care for members discharging from PAC facilities, we recommend the discharging provider team send the discharge summary to the NextBlue care management team via fax or email:

• Fax: 701-781-8093
• Email: CSCND@arkoshealth.com

Questions?
We want to support Post Acute Care facilities throughout this new process. Contact our NextBlue Provider Service Center at (844)753-8039.

Post Acute Care authorization resources can be found at Provider Resources section Provider Resources | NextBlue of North Dakota (nextbluend.com).