Blue Cross Blue Shield of Nebraska will start requiring first day precertification for nonemergency inpatient and observation admissions to hospitals and other healthcare facilities, Omaha World-Herald reports.
The previous policy required the insurer to be contacted about hospital admissions by the fifth day of a stay. Debra Esser, MD, vice president for medical policy and quality medical director at BCBS of Nebraska, said the change will help the insurer identify patients with newly diagnosed chronic illnesses earlier. Dr. Esser said the move also reflects what other insurers in the industry are doing, according to the report.
The change to first day precertification is effective Jan. 1. Customers were notified by letters mailed in November and early December.
Executive vice president of the Nebraska Medical Association Dale Mahlman told Omaha World-Herald the association has not recorded concerns from its physicians, residents and medical students about the change.
Nebraska healthcare facilities will be responsible for charges if they fail to precertify patients according to the new schedule. For patients who come in on the weekend, the facilities have until the next business day to notify BCBS of Nebraska. The requirement will not pertain to hospital stays related to labor and delivery, Medicare supplement members or cases where BCBS of Nebraska is the second insurer.