Upcoming home health and shift care network changes

Effective Saturday, Aug. 1, several home health and shift care agencies will no longer participate in the GHP Family network. These changes will directly impact referral patterns and care continuity for members receiving in-home services.

What’s changing

After Aug. 1, services provided by these agencies may not be covered unless an approved exception is in place. Members receiving care from these providers will either need to transition to an in-network agency or select a different health plan that contracts with their current provider.

Agencies leaving the network

• Elite Staffing Services Inc.
• AccuCare Home Nursing Inc.
• Penn Medical Home Health Care LLC
• Shadai Healthcare Services

What this means for providers

You can expect:

• Increased need to redirect patients to new participating home health or shift care agencies
• Potential disruption for patients receiving ongoing services
• Greater importance of confirming network participation before placing referrals

Referrals to non-participating providers may result in denied claims, delays in care or member billing exposure.

Continuity of care considerations

Limited transition support is available in specific situations:

• Pregnancy: Members may continue with their current provider through pregnancy and postpartum care if the provider agrees to continue services.
• Continuing care: Members receiving active treatment for a qualifying condition may be eligible for up to 60 days of continued care with their current provider, based on timing and authorization.

These provisions are temporary and require coordination with Geisinger Health Plan. They should not be treated as long-term solutions.

Action steps you can take

To minimize disruption and ensure appropriate coverage:

• Verify that all home health and shift care referrals are in-network.
• Reassess patients who may be impacted by provider terminations.
• Begin transition planning early for patients requiring ongoing services.
• Reinforce patients’ understanding of their options when changes affect their care.

Required: Verify before you refer

Always confirm provider participation using the Geisinger Health Plan directory.

This should be a standard step when finding additional care for members to avoid denied services and care gaps.

Note

Behavioral health coverage is not affected by these changes and will continue as usual.

Questions about claims or member benefits

Call 844-GHP-PROV (844-447-7768).
Have other questions? See who to call to get the right answer quickly.