Important Reminders for Skilled Nursing Facilities (SNF)

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) strives to ensure that members have access to Skilled Nursing Facilities (SNF) that deliver high quality care throughout a member’s health care journey.

As a reminder, if a request for SNF ADMISSION or CONTINUED STAY is NOT approved, this is an indicator that either the medical necessity criteria is not met OR the clinical materials submitted for approval were not complete.

It is imperative for requesting providers to submit ALL relevant clinical materials at the time of initial request or in support of an appeal to ensure the health care needs of members are managed expeditiously without placing strain and care uncertainty on the member’s health care journey.

If you have questions about the relevant clinical materials required for these requests, please contact Home & Community Care Transitions (formerly known as naviHealth) for support at 844-801-3686, Monday through Friday, 8:00 a.m. to 5:00 p.m. ET.