Home Administrative Billing & Reimbursement Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Changes to NaviNet® coming in July and October

July 1, 2014

As previously communicated, we are in the process of transitioning our claims processing for AmeriHealth Pennsylvania members to a new platform. Therefore, we will be working with you in a dual claims-processing environment. Providers will likely see a mix of migrated and non-migrated members. Beginning in July, the Eligibility and Benefits Detail screen for migrated AmeriHealth Pennsylvania members will display the National Provider Identifier (NPI) of the member?s primary care physician, where applicable. In addition, in mid-October we will convert all NaviNet offices to the new operating platform. As a result, most providers will see a difference in their provider group drop-down menus within many individual transactions on the NaviNet web portal. Some other significant changes that providers will see on the new platform include the following: NaviNet office will move from a location-specific to a group-specific office configuration. Because there will no longer be a need for duplicate records to differentiate between HMO and PPO lines of business, we will consolidate drop-down lists. Customized provider group name descriptions will be eliminated. Also coming in October, AmeriHealth will introduce a new transaction ? called Allowance Inquiry ? to replace the retired Fee Schedule Inquiry transaction. More information about these changes, including the availability of detailed user guides, will be communicated through future articles in Partners in Health UpdateSM. If you have any questions regarding the NaviNet transaction changes, please call the eBusiness Hotline at 215-640-7410 for providers in Pennsylvania and Delaware and at 609-662-2565 for providers in New Jersey.

NaviNet® is a registered trademark of NaviNet, Inc.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey.
© 2023 AmeriHealth Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer