Post-Acute Care Management: Authorization Process Has Changed

Effective March 1, 2026, Highmark Wholecare moved the management of post-acute care services from Home & Community Care Transitions to the Guiding Care platform for Medicare D-SNP members. This change impacts providers in Pennsylvania who serve Highmark Wholecare D-SNP members at Hospitals, Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, and Long-Term Acute Care Hospitals.

All initial and concurrent authorization requests for post-acute care for D-SNP members must be submitted through Guiding Care, which you can access through NaviNet using single sign-on (SSO). The determination for your D-SNP member’s post-acute authorization will be readily available in Guiding Care.

If you haven't yet registered with NaviNet, we encourage you to do so here.

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

NaviNet is a registered trademark of NaviNet, Inc., which is an independent company that provides a secure, web-based portal between providers and health care insurance companies.