June 28, 2024
Newborn Stay Authorization Policy Update
Thank you for being a Jefferson Health Plans participating provider.
Jefferson Health Plans is revising our authorization policy for obstetrical delivery and NICU nursery care. In July 2021, Jefferson Health Plans implemented an authorization policy that allowed certain NICU and newborn AP-DRG codes to pay without requiring authorization. Effective September 1, 2024, we will be sunsetting this policy and will require all NICU and/or detained newborn admissions to require an authorization.
With the change to this policy, NICU admissions and/or detained newborn admissions (billed with any applicable revenue code(s)) will require an authorization for payment.
Prior authorization requests should be submitted via the HealthTrio provider portal. Please visit our website at www.healthpartnersplans.com/providers for access to the provider portal, training material and resources.
If you have any questions, please call the Provider Services Helpline at 1-888-991-9023 (Monday - Friday, 9 a.m. to 5:30 p.m.).