tango x
Independence Blue Cross
about tango
As skilled home health enablers, tango offers a platform that equips and empowers home health providers with the necessary tools, resources, and support to boost their capabilities, efficiency, and overall effectiveness in providing healthcare services. tango’s partnership with Independence Blue Cross encompasses several key components that aim to enhance the quality and delivery of home health care for Independence Blue Cross’ members:
- Referral coordination and authorization management for skilled home health services: Efficient management of referrals, referral coordination, and authorizations
- Network development and management for skilled home health: Developing, contracting, maintaining, and credentialing a robust network of skilled home health care providers
- Claims payment for skilled home health: Timely and accurate claims payment for the services provided for skilled home health
tango is excited to announce a strategic partnership to expand access and improve quality of Skilled Home Health care in the Pennsylvania region with Independence Blue Cross for Medicare Advantage members in the following plans:
Personal Choice 65SM
Keystone 65
Home Health Providers
Provider Resources
tango’s delegated services will include the following:
| Service | Procedure Codes |
| Skilled nursing services on an intermittent/part-time basis | G0300; G0162; G0299; G0493; G0494; G0495; G0496 |
| Skilled home health aide services on an intermittent/part-time basis | G0156 |
| Physical therapy | G0151; G0157; G0159; G2168 |
| Occupational therapy | G0152; G0158; G0160; G2169 |
| Speech-language pathology | G0153; G0161 |
| Medical social work | G0155 |
Please note that while tango does not authorize behavioral health, respiratory therapy, or home infusion therapy nursing services, we can provide you with contact information for providers offering these services.
Transitioning your members:
To ensure continuity of care for members, Independence Blue Cross and tango are working closely together to facilitate a smooth transition. Starting on May 1, 2025, any Skilled Home Health agency not already contracted with tango for the services mentioned above will be considered out-of-network for Personal Choice 65SM and Keystone 65 members.
Additionally, effective May 1, 2025, all authorizations for Skilled Home Health care services must be in place with tango to receive payment regardless of network status. Authorizations for new admissions to skilled home health care services starting on or after May 1, 2025, must be directed to tango.
Agencies with members under an active episode on or after May 1, 2025 may continue servicing those members by submitting a transitional authorization request to tango prior to May 1, 2025. At that point, tango will provide an authorization to ensure continuity of care for those members.
Please click here to login to our Provider Portal, ProNet Connect to begin submit authorizations.
If you do not have access to the Provider Portal yet, please submit authorization requests via our Upload Center
Please upload the following documents for authorization requests:
- Physician notes regarding member history and physical
- Most recent home health visit note(s).
- Signed order for skilled home health care.
Referral Sources
Resources & Transition Support
Effective May 1, 2025, Skilled Home Health referrals for Independence Blue Cross members will be managed through tango. tango will coordinate directly with Skilled Home Health providers and facilitate the placement of referrals and the authorization of services.
This is a change to the current referral management and prior authorization process and will streamline referral placement and ensure timely start of care. To that end, please submit all referrals to tango, rather than directly to Skilled Home Health providers, effective 5/1/2025.
A referral can be submitted to tango through multiple channels. tango has access to several hospital discharge planning platforms, including WellSky CarePort, Strata, MorCare and Ensocare, and can access these systems and retrieve the referrals directly without any change needed to the hospital discharge planning process.
- In the event your EMR is through epic, tango can work with your organization to become a registered user of your instance and receive your referrals through your epic discharge planning. If you utilize epic or a system not named above, please reach out to tango at referralsource@tangocare.com to discuss your alternative EMR or discharge planning software.
- For sub-acute facilities and community-based providers, a skilled Home Healthcare referral can be made directly to tango via its dedicated referral site at https://referralrequest.com.
Webinars
Referral Source Webinars:
These sessions are specifically designed for upstream referral sources, including Acute, Post-Acute Care (PAC), and Community-based physicians. This training will provide clear instruction on how to submit referral requests to tango, enabling our staffing team to process them promptly and ensure a smooth, timely transition to the selected home health provider. We will also review the methods for submission and necessary documentation needed to approve prior authorization. This will reduce the administrative burden and streamline the patient transition process, ensuring high-quality coordination.
Who should attend? Upstream providers listed above, including clinical and operations leaders, case managers, home health liaisons, and social workers.
Additional Resources
For assistance or information regarding skilled home health authorizations, program inquiries and feedback, training requests, language assistance, and general questions, please contact the tango team.
Frequently Asked Questions
General Questions
tango is the largest independent, risk-bearing, post-acute benefit management solution in the marketplace. Today, tango goes beyond utilization management to improve access to care and deliver better outcomes.
tango manages skilled home health referrals by placing referrals with high-quality providers, performing utilization management, and claims payment. tango also provides performance-based analytics to its provider network. In some markets, tango offers value-based incentives to optimize the network by driving quality outcomes.
Authorization Process
Referrals must be submitted by the referral source (hospital, post-acute care provider, community-based physicians, or extenders) to tango using their care management tool, www.referralrequest.com or via fax at 833-481-3441.
Completed prior authorization form is required for fax submissions; Available under Provider Materials at: tango Provider Materials
Signed or verbal home healthcare order is required from a: MD, DO, DPM, NP, or PA.
Supporting Clinical Documentation:
- History & Physical (H&P).
- Inpatient Discharge Summary.
- Hospital or Skilled Nursing Facility (SNF) notes, including therapy notes.
- MD Office Notes.
- Wound Care Notes with Measurements.
Prior authorizations will be processed timely, usually within the same business day providing all required documents are submitted with the request and medical necessity is met.
Select “Re-auth” in the patient’s record within ProNet Connect and complete. Upload clinical documentation with request.
Turnaround time (TAT) for re-authorization: typically, 2-5 business days if all necessary documents (see below) are received for clinical determination. Please keep in mind the TAT when submitting requests to avoid a delay in care.
There is no retro grace period for concurrent or reauthorization requests.
All visit notes for each discipline requested
OASIS (SOC, ROC, recertifications) and 485 POC if not already submitted
SN notes: Up to day color/dated photos and measurements of wounds, Foley details (size, frequency), MD/WCC notes.
Therapy notes: Weight-bearing status, flexion for knee replacement, maintenance program documentation, progress, and goals.
Speech therapy: Diet and diagnosis, cognition therapy if applicable.
Home Health Aides: For patients needing hands-on assistance with ADLs
ProNet Connect & Dina
This is our authorization portal for processing authorizations requests, allowing providers to track authorization status. It includes a single sign-on feature with our referral management platform, dina.
dina is tango’s referral management platform, allowing referrals to flow seamlessly to home health agencies for review, acceptance, evaluation, or decline. How does tango determine which agencies receive referrals?
- Based on coverage area, which is determined during the contracting process.
- If your agency is not fully contracted and credentialed, please reach out to tango for assistance.