Medicare AdvantageMarch 27, 2024
Requesting authorizations for post-acute care services
Prior authorization requests for admission to (or concurrent stay in) a skilled nursing facility (SNF), an inpatient acute rehab facility (IRF), or a long-term acute care hospital (LTACH) for Medicare Advantage Individual, Group Retirees, and most Dual-Eligible Plan members are reviewed by Carelon Post Acute Solutions (CPAS). These requests should not be submitted through Availity. To prevent any misrouting of members’ care information, please use the process below to submit requests.
How to submit or check a prior authorization request
Go to portalct.mynexuscare.com to get started. You can upload clinical information and check the status of your requests through this online tool seven days a week, 24 hours a day. If you are unable to use the link, you can call the CPAS Provider Call Center at 844-411-9622 during normal operating hours from 7 a.m. to 7 p.m. CT, Monday through Friday.
Note: Authorization requests for Highly Integrated Dual Eligible (HIDE), Fully Integrated Dual Eligible (FIDE), MMP, and Risk plan members should be directed to Anthem.
We are excited for genuine collaboration with you, our care provider partners.
Carelon Post Acute Solutions, LLC is an independent company providing services on behalf of the health plan.
Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
CABC-CR-053581-24-CPN53152
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