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Humana - PDPM to Levels

Humana is in the process of switching their reimbursement from PDPM to Levels. This change has occurred on 1/1/21 for some SNF’s and 6/1/21 for other SNF’s. For the SNF’s that have received notification from Humana regarding the reimbursement change at 1/1/21, we have noticed facilities receiving approvals at Level 1 or Level 2. Navihealth has approved some residents at Level 1 when they met Level 2 requirements. Please review your residents to ensure the level they are assigned is accurate and to avoid missing out on much needed revenue. Based on Humana’s standard level payments, the difference between Level 1 and Level 2 is $70 per day.

Do you think you might be missing out on revenue? Give us a call, we're happy to review.