Ascension Providers

Fecha: 21/05/24

Thank you for being a participating provider with Ambetter of Tennessee. We understand that Ascension’s recent cybersecurity incident has disrupted several of its operational systems and processes. To ensure member access and continuity of care as Ascension works to address impacted systems and processes, we are extending the following accommodations to Ascension providers beginning 5/8/2024 through 6/8/2024 or Ascension’s remediation date – whichever date is sooner.  Barring earlier remediation, Ambetter of Tennessee will assess the need for continued flexibilities on 6/8/2024 and update you accordingly. 

• Prior authorization (PA) for home health and post-acute care requests for discharging members is waived. For skilled nursing and inpatient rehabilitation requests, Ambetter of Tennessee will authorize five (5) business days upon notification of admission by the receiving facility. Home health will be approved for the initial certification period upon receipt of the retrospective request from the home health agency. Please prioritize use of in-network facilities and agencies. 
• Authorizations for Ascension that are currently in process, but pending additional clinical information, will be reviewed using available information obtained telephonically. 
• Ambetter of Tennessee will allow reconsideration of Ascension claims denied due to no authorization. Timely notification will be waived during the accommodations time period set forth above. Prior authorizations will be reviewed retrospectively for medical necessity appropriateness. 
• Ambetter of Tennessee reserves the right to retrospectively review all provided services for medical necessity. 

We appreciate Ascension’s continued partnership in providing our members with safe, timely and appropriate care during this time. If you have any additional questions, please contact Provider Services at 1-833-709-4735.