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Provider Manual

Skilled Nursing Facility Care

Last Updated on October 25, 2021
  • Benefits are limited to the number of days specified in the member’s plan. Coverage is provided to members with a skilled nursing facility (SNF) benefit. The member's medical condition must also require daily nursing or therapy care for the same condition or diagnosis as the qualifying hospitalization. The patient must require daily skilled services as certified by the member’s physician. SNF must prior authorize skilled nursing facility admissions with naviHealth at (phone) 855-512-7002 or (fax) 855-847-7243. For more information about naviHealth click here.
  • Confinement in a swing bed in a hospital is considered the same as SNF confinement. Services require prior authorization and approval by Security Health Plan in order to be considered for coverage. Prior authorization is required by calling Security Health Plan at 1-800-548-1224 or by submitting a prior authorization.
  • Custodial care is excluded from coverage. This includes, but is not limited to, care provided by community based residential facilities (CBRF), intermediate care facilities (ICF), day care and group facilities, and residential hospice facilities.