Effective May 1, 2025, Independence Blue Cross (IBX) has delegated skilled home health network development and management, referral coordination and authorization management, and claims payment processing for its Medicare Advantage members with Personal Choice 65SM or Keystone 65 to tango, an independent company.
Delegated functions
tango now manages:
- Network development and management. Developing, maintaining, and credentialing a robust network of skilled home health care providers.
- Referral coordination and authorization management. Efficient management of skilled home health referrals, referral coordination, and authorizations.
- Claims payment processing. Timely and accurate claims payment for the services provided under this delegation.
Delegated services
tango's delegated skilled home health services include:
- Skilled nursing services on an intermittent/part-time basis
- Home health aide services on an intermittent/part-time basis
- Speech-language pathology
New claim payment policy
For more information, please refer to the new Medicare Advantage policy, MA00.054: tango Home Health Care Services Management, and section 10 of the IBX Hospital Manual.
Authorization and claims submission
Effective May 1, 2025, the Provider Engagement, Analytics & Reporting (PEAR) portal should no longer be used to submit skilled home health care authorizations for IBX Medicare Advantage members. As of May 1, 2025, all authorizations for Skilled Home Health care services must be in place with tango to receive payment. For new admissions starting on or after May 1, 2025, authorizations must be directed to tango. For information on transitional authorizations, please contact providerrelations@tangocare.com.
Open prior authorization requests with IBX will be loaded by tango as of May 1, 2025. Providers do not need to submit existing prior authorization requests to tango.
Effective May 1, 2025, claims for skilled home health care services for dates of service on or after May 1, 2025, should be submitted to tango.
Home health referrals
Effective May 1, 2025, all skilled home health referrals for IBX Medicare Advantage members should be sent to tango. A referral can be submitted to tango through multiple channels. tango has access to several hospital discharge planning platforms, including WellSky CarePort/CarePort, Strata, MorCare, and Ensocare and can access these systems and retrieve the referrals directly without any change needed to the hospital discharge planning process.
If the hospital you are referring your patient from is not using one of these discharge planning platforms, please reach out to tango for an alternative referral submission channel.
For sub-acute facilities and community-based providers, a skilled home health referral can be made directly to tango at referralrequest.com.
tango will be hosting live webinars to familiarize facilities and referring providers with the tango model, including detailed guidance on submitting skilled home health referrals for your patients.
To register for a webinar, please reach out to tango's dedicated Provider Relations team at providerrelations@tangocare.com.
For additional questions or more information, contact tango directly:
24-0199