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Reminder: Provider self-service requirements effective September 15, 2011

September 1, 2011

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In our continuing efforts to provide the most current and reliable information to our network providers, effective September 15, 2011, we will enforce our policy that requires providers to use the NaviNet? web portal or the Provider Automated System when requesting member eligibility.

In addition, providers will be directed to use NaviNet or call the Provider Automated System when checking claims status information. The claim detail provided through either system includes specific information, such as:

  • check date
  • check number
  • service codes
  • paid amount
  • member responsibility
  • To assist you in using these transactions in NaviNet, new user guides were recently posted in the Administrative Tools & Resources section of AmeriHealth Plan Central.

    If your office location is not yet registered for NaviNet, please visit www.navinet.netand select Sign up from the top right. If your office is currently NaviNet-enabled but would like training on how to access member or claims information, please call the eBusiness Provider Hotline at 215-640-7410 for providers in Delaware and Pennsylvania 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.

    ]

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