As of September 15, 2011, we
began enforcing our policy that requires providers to 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
- member
responsibility
Providers can view a webinar at www.navinet.net/intro_pss_ibc 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 for NaviNet, please visit www.navinet.net 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.
Providers without access to NaviNet
must obtain eligibility and claims status information through the Provider
Automated System by calling 1-800-ASK-BLUE and
following the voice prompts.