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Reminder of recent changes to NaviNet®

October 1, 2015


As previously communicated, several new transactions and enhancements were introduced on the NaviNet web portal in September:
  • Cash Management. This new transaction provides a summary of payments applicable to members for the current six-month period (migrated member claims only). The designated NaviNet Security Officer within your office received access to this new transaction, and he or she will manage permissions for individual associates. For more about this new transaction, refer to the new Cash Management Guide, now available in the NaviNet Resources section of our Provider News Center.
  • Provider File Management. This new transaction has replaced the Provider Change Form transaction. Provider File Management allows professional providers to modify practice information, add hospital affiliations, and add participating providers.
  • ICD-10. Portal transactions that reference or leverage diagnosis codes were updated to include ICD-10 codes only. As a reminder, providers must now use ICD-10 codes when submitting referrals, encounters, and authorization requests or when searching for a diagnosis on NaviNet (for dates of service or dates of discharge [for facility inpatient claims] on or after October 1, 2015).
  • COB Questionnaire. A new transaction was introduced with a new Coordination of Benefits (COB) Questionnaire. This electronic form allows providers to report and submit Other Party Liability coverage for members. Reporting COB information at the time of service helps claims process correctly.
  • Allowance Inquiry. New pricing mechanisms were introduced to this transaction to help professional providers with rate searches. An updated Allowance Inquiry Guide is available in the NaviNet Resources section of our Provider News Center.
If you have any questions, please call the eBusiness Hotline at 609-662-2565 for AmeriHealth New Jersey and at 215-640-7410 for AmeriHealth Pennsylvania.

Submitting authorizations with ICD codes

When submitting an authorization request through NaviNet, do not include the decimal point when entering diagnosis codes. Use the ICD-9 code (for dates of service prior to October 1, 2015) or ICD-10 code (for dates of service on or after October 1, 2015).

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