As previously communicated, providers must use the NaviNet
? web
portal in order to initiate the following authorization types:
medical/surgical procedures
chemotherapy/infusion therapy
durable medical equipment
emergency hospital admission notification
home health
dietitian
home health aide
occupational therapy
physical therapy
skilled nursing
social work
speech therapy
home infusion
outpatient speech therapy
Please note that the representatives at the Health Resource Center are no
longer able to initiate the authorizations listed above.
Tips for submitting authorizations
NaviNet submissions that result in a pended status can take up to two business
days to be completed. These may include requests for additional clinical
information as well as requests that may result in a duplication of services.
If the authorization remains pended beyond two business days, or if the
authorization request is urgent, providers should call
1-800-275-2583 for assistance.
Requests for medical/surgical procedures can be made up to six months in
advance on NaviNet, and in most cases, requests for medically necessary care
are authorized immediately.
In some instances, providers can modify the date of service previously approved
by selecting Authorizations from the Plan Transactions menu and then
Authorization Status Inquiry.
About NaviNet
For your convenience, NaviNet is available to all participating providers
Monday through Saturday, 5 a.m. to 10 p.m., and Sunday, 9 a.m. to 9 p.m. If
your office location has not yet registered for NaviNet, go to
NaviNet and select Sign up from the top
right. If your office is currently NaviNet-enabled and would like training on
how to submit authorizations, please call the eBusiness Provider Hotline at
215-640-7410 for providers in Pennsylvania and
Delaware or
609-662-2565 for providers in New Jersey.
Note: This information does not apply to providers
contracted with Magellan Behavioral Health, Inc. Magellan-contracted providers
should contact their Magellan Network Coordinator at 1-800-866-4108 for authorizations.
Magellan Behavioral Health, Inc. manages mental health
and substance abuse benefits for most AmeriHealth members.
NaviNet? is a registered trademark of NaviNet,
Inc., an independent compnay.