DECEMBER 9, 2021 | COMMUNICATION BULLETIN 2021-22 ISSUE 31 IN THIS ISSUE: Q&A Webinar for Vaya and Cardinal Innovations Network Providers | Updated Inpatient Hospitalization Authorization Guidelines for Cardinal Innovations Providers | Cardinal Innovations Provider Transition Guide
Q&A Webinar for Vaya and Cardinal Innovations Network Providers Dec. 17, 2021, 11 a.m.-12 p.m. Vaya’s Provider Q&A Webinars are an important source of the most up-to-date information on topics that affect Vaya and Cardinal Innovations network providers during consolidation. Registration is not required. All network providers are encouraged to attend.
Q&A WEBINAR FOR VAYA/CARDINAL NETWORK PROVIDERS – DEC. 17, 2021
Updated Inpatient Hospitalization Authorization Guidelines for Cardinal Innovations Providers Cardinal Innovations has updated its Inpatient Hospitalization authorization guidelines effective Dec. 18, 2021, for network providers transitioning to the Vaya network. For dates of service from Dec. 18-31, 2021, Cardinal Innovations will not require prior authorization for submission of claims for inpatient psychiatric treatment. Providers wishing to submit authorization requests for these dates of service may continue to do so. For any Cardinal Innovations member who is admitted prior to Dec. 18 or utilizing the 14-day pass through, an authorization will not be required for concurrent requests. You may simply follow the new guideline and continue to have no authorization on file. Any authorizations on file at this time will remain effective until the next re-authorization is required. Upon next review after Dec. 18, authorization requests will be reviewed under new authorization guideline expectations. Please note that all services are subject to post-service review. For dates of service starting Jan. 1, 2022, prior authorization requests must be submitted to Vaya. Beginning Jan. 3, 2022, all new requests for inpatient care that require prior authorization should be submitted through Vaya’s AlphaMCS system. Vaya will process retroactive requests for services
going back to Jan. 1 as long as the request is submitted on or before Jan. 16, 2022. Please note that Vaya’s authorization guidelines for inpatient care differ from Cardinal’s guidelines with respect to pass-through requirements. Vaya requires that providers submit an admission notification Service Authorization Request (SAR) and any required documentation within 48 hours of admission. However, providers transitioning from Cardinal may submit inpatient care requests as soon as possible from Jan. 3-16, 2022. If you have questions about the Cardinal Innovations guidelines, please email the Utilization Management Department at UtilizationM@cardinalinnovations.org. If you have questions for Vaya, please contact Vaya’s Utilization Management Team at 1-800-893-6246, ext. 1513, or at UM@vayahealth.com.
Cardinal Innovations Provider Transition Guide Cardinal Innovations network providers transitioning to Vaya are asked to review the Provider Transition Guide for guidance. The guide includes information about contracts, authorizations, a map of the new county alignments, and more. Read more.
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