Effective April 20, 2020, there will be a change to the services that are delegated to Tandigm Health (Tandigm) for precertification and/or concurrent review for members who have a Tandigm primary care physician (PCP).
Delegated services
The following services will continue to be delegated to Tandigm:
- skilled nursing facility (SNF) admissions;
- all home health services, excluding infusion therapy;
- acute inpatient rehabilitation;
- elective (nonemergency) ground, air, and sea ambulance transport;
- out-of-network and out-of-capitation laboratory, radiology, and occupational and physical therapy.
Independence has reassumed precertification for these services previously delegated to Tandigm:
- inpatient elective admissions;
- long-term acute care (LTAC);
- select outpatient procedures (bariatric, Carticel®, cochlear implant, and uvulopalatopharyngoplasty);
- reconstructive and potentially cosmetic procedures;
- prosthetics/orthotics and durable medical equipment, except continuous positive airway pressure;
- medical foods;
- continuity of care;
- day rehabilitation;
- hyperbaric oxygen therapy.
This does not change the initial precertification request process through the NaviNet® web portal (NaviNet Open).
Affected facilities (hospitals and SNFs) can continue to contact Tandigm directly by calling
1-844-TANDIGM (1-844-826-3446), option
5, or by sending a fax to
215-238-2271. Independence discharge planning staff can also direct facilities to Tandigm when requesting placement for Tandigm members. Continued stay/concurrent review for these admissions is managed by Tandigm.
Learn more
If you have questions related to submitting authorization requests to Independence, please review our
NaviNet® Open Authorizations transaction FAQ.
NaviNet® is a registered trademark of NantHealth, an independent company.