HomeAdministrativeBilling & ReimbursementBlueCardHealth and WellnessMedicalNaviNet OpenPEAR portalPharmacyProductsQuality Management

NaviNet Open

New NaviNet® user guides available soon 

August 29, 2013    

As previously communicated, beginning September 27, 2013, you will begin to see the changes to the NaviNet web portal that will affect the way you do business with IBC. These changes are being made as IBC transitions to a new operating platform, which will offer greater capabilities, increased flexibility in benefit design, and enhanced functionalities for an improved overall customer experience.

To help you better understand these changes, we will make available new user guides by mid-September that will describe the following NaviNet transactions in detail:

  • Claim Status Inquiry (including Claims INVESTIGATION)
  • BlueExchange Out of Area (Eligibility and Benefits Inquiry, Claim Status Inquiry)
  • Eligibility and Benefits Inquiry
  • Encounter Submission

Given the significant number of changes to be implemented, we urge you to review these new user guides prior to September 27. They will be available in the NaviNet Transaction Changes section of our Business Transformation website. Announcements will be made on NaviNet Plan Central and on our Provider News Center once the new guides are posted. Please check these sites frequently for updates.

Self-service webinars will also be made available in September. An announcement will be made on IBC NaviNet Plan Central when they are available.

Reminder: Interruption for some transaction functionality

As we continue our work with transitioning to the new platform, some functionality will be disabled or temporarily suspended starting September 27, 2013, including the following:

  • Clear Claim ConnectionTM. This transaction is a web-based reference tool designed to evaluate code combinations during the auditing of professional claims. By accessing the tool, the user can view the justifications and clinical rationale on how a professional claim processes. On September 27, 2013, this NaviNet transaction will be disabled. It will be released again in April 2014. However, this tool will remain available to all providers in the Clear Claim ConnectionTM section of our website.
  • Clinical Alerts and Clinical Care Reports. Clinical Alerts and Clinical Care Reports will be temporarily disabled starting September 27, 2013. The Clinical Alerts feature is a clinical practice tool that alerts providers when their patients have not received a recommended service. Currently, Clinical Alerts are available to primary care physicians, cardiologists, OB/GYNs, and endocrinologists. Beginning in December, access to Clinical Alerts will be re-established and will be expanded to all provider specialties.
  • Fee Schedule Inquiry. This transaction will be temporarily disabled starting September 27, 2013, and it is scheduled to be re-introduced in the first quarter of 2014. Until this transaction becomes available again next year, please contact your Network Coordinator for fee schedule inquiries.
  • Provider Change Form. This transaction will be temporarily disabled starting September 27, 2013. Until it becomes available again, professional providers should complete a Provider Change Form or contact their Network Coordinator to make any provider record changes.

For the most up-to-date information about our transition to a new claims processing platform, we encourage you to frequently visit our Business Transformation website. If you have any questions regarding upcoming NaviNet transition changes please call the Business hotline at 215-640-7410.

NaviNet® is a registered trademark of NaviNet, Inc., an independent company.

Connect with us    Facebook     Twitter     Flickr     YouTube    Walk the Talk   Independence Pinterest   Independence Google+   Independence LinkedIn   Independence InstagramSite Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2020 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.