Blue Cross Blue Shield of North Dakota (BCBSND) will begin admission notification for members that directly transfer from an inpatient hospital or residential treatment center started December 13, 2021. We understand the need for members to gain access to alternative treatments at time of discharge. In an effort to alleviate the delay in members accessing care when directly transferred from an inpatient hospital or residential treatment center, BCBSND will be implementing an admission notification process. Admissions that are not a direct transfer will follow the normal precertification process.
Admission notification of the transfer of patients to these services should be made to BCBSND via Availity. 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 care service covered during direct transfer include the following:
- Inpatient Rehab Facilities
- Long Term Acute Care Facilities
- Partial Hospital Programs
- Residential Treatment Centers
- Skilled Nursing Facilities
- Transitional Care Units
Precertification will continue to be required for alternate care services requested for Federal Employee Program (FEP). If you have questions, please email: prov.partners@bcbsnd.com.
