As previously communicated, providers must use the NaviNet
? web
portal or the Provider Automated System when requesting member eligibility.
In addition, providers must use NaviNet or call the Provider Automated System
to check claims status information. The claim detail provided through either
system includes specific information, such as check date, check number, service
codes, paid amount, and member responsibility.
Providers can view a webinar for more information on these requirements. The
presentation offers guidance on where to obtain member eligibility and claims
status information through NaviNet.
If your office location is not yet registered, please visit NaviNet and select
Sign up from the top right. If your office is currently NaviNet-enabled
but would like assistance with accessing member or claims information, please
call the eBusiness Provider Hotline at
215-640-7410
for providers in Pennsylvania or Delaware or
856-638-2701 for providers in New Jersey.
Providers without access to NaviNet must obtain eligibility and claims status
information through the Provider Automated System by calling
1-800-275-2583 and following the voice prompts.
NaviNet® is a registered trademark of
NaviNet, Inc.