Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Changes to precertification services delegated to Tandigm Health

April 3, 2020

Effective April 20, 2020, there will be a change to the services that are delegated to Tandigm Health (Tandigm) for precertification and/or concurrent review for members who have a Tandigm primary care physician (PCP).

Delegated services

The following services will continue to be delegated to Tandigm:

  • skilled nursing facility (SNF) admissions;
  • all home health services, excluding infusion therapy;
  • acute inpatient rehabilitation;
  • elective (nonemergency) ground, air, and sea ambulance transport;
  • out-of-network and out-of-capitation laboratory, radiology, and occupational and physical therapy.

Independence has reassumed precertification for these services previously delegated to Tandigm:

  • inpatient elective admissions;
  • long-term acute care (LTAC);
  • select outpatient procedures (bariatric, Carticel®, cochlear implant, and uvulopalatopharyngoplasty);
  • reconstructive and potentially cosmetic procedures;
  • prosthetics/orthotics and durable medical equipment, except continuous positive airway pressure;
  • medical foods;
  • continuity of care;
  • day rehabilitation;
  • hyperbaric oxygen therapy.

This does not change the initial precertification request process through the NaviNet® web portal (NaviNet Open).

Affected facilities (hospitals and SNFs) can continue to contact Tandigm directly by calling 1-844-TANDIGM (1-844-826-3446), option 5, or by sending a fax to 215-238-2271. Independence discharge planning staff can also direct facilities to Tandigm when requesting placement for Tandigm members. Continued stay/concurrent review for these admissions is managed by Tandigm.

Learn more

If you have questions related to submitting authorization requests to Independence, please review our NaviNet® Open Authorizations transaction FAQ.

NaviNet® is a registered trademark of NantHealth, an independent company.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.