CareCentrix Post-Acute Care Services

Optima Health has contracted with CareCentrix to manage post-acute care services for our commercial members in Virginia, effective October 1, 2021 (previously scheduled to start on August 1).

Here are the key details:

  • CareCentrix will manage authorizations for members discharged from acute care hospitals who are admitted to skilled nursing facilities or inpatient rehabilitation facilities.
  • CareCentrix will provide nurse coaching for eligible patients after an acute care hospital discharge for a period of up to 90 days to support their path to healing, reduce unnecessary readmissions, and help members achieve self-management.
  • Optima Health will continue to manage authorizations for all other services.

If providers do not obtain authorization as described above, on or after October 1, 2021, claims may be denied.

Claims processes are not changing. Please continue to submit claims, claims questions and claims appeals to Optima Health.

CareCentrix will contact you shortly to provide additional information about training for the authorization process you will begin using on October 1, 2021.

If you have questions about Optima Health services, please contact your network educator at (877) 865-9075, option #2.