Post-Acute Care Management: Authorization Process Changing

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Post-Acute Care Management: Authorization Process Changing

  • WPA/NEPA
  • CPA/SEPA
  • WV

For: Professional and Facility Providers

Effective March 1, 2026, Highmark is moving the management of post-acute care services — including initial and concurrent authorizations — from Home & Community Care Transitions to Helion Arc Technology platform for Medicare Advantage (MA) members.

This change will impact providers in Pennsylvania and West Virginia who serve MA members at the following locations: 

  • Hospitals
  • Skilled Nursing Facilities (SNFs)
  • Inpatient Rehabilitation Facilities (IRFs)
  • Long-Term Acute Care Hospitals (LTACHs)

Simplified Authorization Submission

Starting March 1, 2026, all initial and concurrent authorization requests for post-acute care for MA members must be submitted through Availity Essentials. The determination for your MA member’s post-acute authorization will be readily available in Helion Arc, which you can access through Availity using single sign-on (SSO).

Sign Up for a Training Webinar

To ensure a seamless transition, Highmark and Helion will be hosting comprehensive training webinars in 2026 tailored to each impacted care setting. We highly recommend watching the Availity Essentials training video on "Authorizations & Referrals" prior to participating in this webinar. You must be a registered Availity user with active credentials to access the video. If you aren’t already a registered Availity user, you can create an account HERE.

Choose the hour-long session that best fits your schedule and register today:

  • wpa/ nepa
  • cpa/ sepa

Need More Information?

For additional questions, contact the Provider Service Center for your region or reach out to your assigned Helion Network Performance Manager.

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