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 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. Note: Per upcoming NaviNet
requirements, you must register by April 1, 2013. To register, please visit NaviNet and select Sign Up from the top right.
NaviNet® is a registered trademark
of NaviNet, Inc., an independent company.