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COVID-19 Updates for Providers

from iCare Prior Authorization

April 16, 2020

 

 

 

Attention:  Acute and Subacute Providers

The global coronavirus pandemic is affecting people and businesses around the world.  Our priority is the health and safety of our members, employees, providers, and communities as well as business continuity to provide support and services to our members.  We are following guidelines set by the CDC and local authorities and are carefully monitoring this rapidly changing situation. 

iCare has determined that the removal of the Prior Authorization requirement in advance of transferring from acute to subacute facilities will better serve our members and lighten the burden on our providers during the coronavirus pandemic .  Therefore, starting 4/20/2020, all new admissions from acute facilities to skilled nursing facilities will be granted a guaranteed 5-day authorization without a clinical review.  Any currently authorized stays will be subject to a less onerous review and longer review periods.

Please continue to use the Subacute PA request form for new requests that can be found on our website at:

https://www.icarehealthplan.org/Files/Resources/PROVIDER-DOCS/Subacute-PA-Form.pdf

Your requests for continued stay will be subject to a simplified review process after the initial authorization to allow you to spend your time caring for members.  The simplified review will require you to keep us abreast of the members:

-admission status

-diagnosis

- if or when a discharge date is planned

- alert at time of discharge

This process will be in place for the remainder of the emergency at which time we will revert to standard policy and procedures.

iCare will continue to partner with our providers in providing quality care for our members. Please let us know if your organization has implemented or is planning to implement any changes that may impact hospitalizations or transitions of care. 

We appreciate your feedback and commitment as we manage through this time together.  Please forward this information onto your department liaisons, supervisors, directors, and management as needed.

For questions about our process please call:
Prior Authorization Department at 414-299-5539 or 855-839-1032

For questions regarding the status of your authorization please call:
Customer Service at 414-223-4847

 

Thank you and Stay Safe,

Mary Ellen Benzik, M.D.
Chief Medical Officer

IC2432_C Last Updated 4/21/20

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