These enhancements include auto-approvals as well as a single location to submit both acute inpatient admissions and outpatient medical and radiology service preauthorizations.

To Submit Online Preauthorzations

Like always, you will submit and manage online preauthorization by logging into NaviNet. Once logged in, you’ll see new links labeled “Inpatient Precertification" and “Medical/Radiology Preauthorization." The inpatient precertification link should be used for acute inpatient admissions and concurrent review requests. The medical/radiology preauthorization option should be used for all outpatient medical and radiology requests. The look and feel of the preauthorization section will also look a bit different. The new preauthorization process is now powered by Altruista Health, a best-in-class system focused on streamlining provider workflow.

The options for Clear Coverage will no longer be available after 31/12/2020.

Creating a NaviNet account to manage preauthorizations will eliminate the manual process of submitting requests by fax or phone. However, you will still have that option if needed.

To create a NaviNet account, submit a preauthorization, or access helpful tips and videos, please visit Nebraskablue.com/Providers/Preauthorization.

Some helpful reference guides you’ll find there include:

• Preauthorization Enhancements Overview Presentation
• Preauthorization Tool Frequently Asked Questions
• Preauthorization Tool User Guide
• Medication with Buy and Bill Quick Reference Guide
  Outpatient:

• Outpatient Quick Reference Guide
• Outpatient Preauthorization Tool Overview Presentation

Inpatient:

• Inpatient Quick Reference Guide
• Inpatient Preauthorization Tool Overview Presentation

Out-of-area providers must always log in directly through their local Host Plan portal to conduct pre-service reviews.

Using your local Host plan portal and upon logging in, you’ll see new links labeled “Inpatient Precertification" and “Medical/Radiology Preauthorization." The inpatient precertification link should be used for acute inpatient admissions and concurrent review requests. The medical/radiology preauthorization option should be used for all outpatient medical and radiology requests. The look and feel of the preauthorization section will also look a bit different. The new preauthorization process is now powered by Altruista Health, a best-in-class system focused on streamlining provider workflow.

The options for Clear Coverage will no longer be available after 31/12/2020.

Creating a NaviNet account via your local Host portal to manage preauthorizations will eliminate the manual process of submitting requests by fax or phone. However, you will still have that option if needed.