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Connecticut: Starting July 1, you must use Anna™ for the SNF concurrent review process

 

Aetna® has partnered with Post-Acute Analytics (PAA) to automate the concurrent review process by using their Anna™ software platform.

 

PAA is a business associate that works with health systems, payers and post-acute providers. PAA works with providers and payers that participate in Medicare Advantage (MA) plans and programs to help them understand how members receive care across the care continuum.

 

What’s changing?

 

Starting July 1, 2022, all skilled nursing facilities (SNFs) in Connecticut that admit Aetna Medicare Advantage members who reside in and receive care in those states will be required to work with PAA and use Anna to:

 

  • Notify Aetna of a member’s arrival in the facility (admission verification notification)
  • Conduct concurrent review processes, including providing clinical documentation to receive authorization of additional days beyond the initial approved days

 

The precertification and concurrent management process

 

Aetna will continue to make utilization management decisions and send the appropriate letters and other communications.

 

PAA will provide clinical programming services for identified SNF partners, with the oversight of their Chief Clinical Officer and Senior Medical Officer. One of these services is a root cause analysis, which PAA does to ensure that members receive appropriate care and services. The goal is to prevent unnecessary readmissions and to make sure members get the right follow-up care.

 

How to start using Anna

 

PAA will contact you soon to walk you through how to set up and use this exciting tool. It will reduce manual processes, decrease administrative burden and streamline communication with Aetna utilization managers. This can lead to better clinical outcomes and make working with Aetna easier.

 

Aetna and PAA may integrate your electronic medical records (EMR) system with Anna. You will not be charged any fees from Aetna or PAA. The integration is important for high-volume providers, since it will make working with Aetna simpler.

 

One of PAA’s Post-Acute Care (PAC) engagement managers will contact you to schedule a meeting and answer questions. If you prefer to contact PAA directly, you can:

 

 

Sending “continued stay” documentation

 

Use the Anna portal (which is the preferred method) to send “continued stay” documentation. Note that you should continue to send pre-certification documents via Availity®.*

 

How to reach us

 

If you have questions for Aetna about this change, you can send us an email message.

 

If you have questions about the Aetna utilization review process, you can contact your facility’s assigned utilization review nurse or the Provider Contact Center at 1-888 MD AETNA (1-888-632-3862) (TTY: 711).

 

*Availity is available only to providers in the U.S. and its territories.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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