On December 30, 2016, Horizon Blue Cross Blue Shield of New Jersey announced an agreement with naviHealth, which will be effective on February 1, 2017. naviHealth is a national post-acute care management company which will help manage Nursing Facility and Rehabilitation services.

Horizon BCBSNJ is pleased to offer providers an opportunity to attend an in-person overview to learn more about this new relationship with naviHealth and its role in managing post-acute care for our Medicare Advantage (MA), Dual-Eligible Special Needs Plan (DSNP) and Medicare Advantage Preferred Provider Organization (MA PPO) members. Representatives from naviHealth and Horizon BCBSNJ will be presenting information about the data tools naviHealth uses to assess patients, as well as how naviHealth care coordinators will interact with your members and your staff in New Jersey. We will also share information about how this relationship will help our members more efficiently navigate through the process of setting up post-acute care services.

naviHealth Educational Meeting Schedule

As stated in our announcement this will bring a personalized approach to support all MA programs including DSNP and MA PPO members.

As a reminder, naviHealth offers a comprehensive suite of functional assessment and clinical decision-support solutions to support evidence-based care.

As part of this program, prior authorization must be obtained from naviHealth for admissions to and concurrent stays in Swing Beds, Skilled Nursing Facilities (SNF), and Inpatient Acute Rehab Facilities (IRF). Horizon BCBSNJ will retain responsibility for authorizing other post-acute care settings such as Long Term Acute Care Hospital (LTAC) and Home Health Services (HHS), as well as Durable Medical Equipment (DME), ambulance services, and other benefits.

Who should attend these meetings?

The most appropriate representatives from your facility would be the facility administrator, director of rehab (including contract therapy provider if appropriate) and directors of case management or discharge planning. Other representatives are welcome to attend, but should do so in addition to those named above. We recognize that you need to spend as little time away from your facility as possible, but attending one of these sessions can help you and your staff better understand the service delivery naviHealth brings to post-acute care.

Three meeting dates and locations throughout New Jersey are available for your convenience. There will be morning and afternoon sessions on each date. Each session will be two hours in length so we can discuss our new relationship with naviHealth, the post-acute care process changes, and how they will affect your organization. The list of dates and times is available below.

Registering for your session in advance will help us plan for a comprehensive presentation. Please email Charyl.Bersuder@navihealth.us with the following information:

• Name and address of your facility
• Name and title of individual(s) attending
• Phone number and email address of attendee(s), in case we need to contact you
• Location and session selection
• Average number of Horizon BCBSNJ member admissions to your facility per month

We look forward to meeting you and establishing this collaboration with your facility at these sessions.