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Authorization submission requirements through NaviNet®

August 2, 2018

We appreciate your continued patience during our transition to a new utilization management system and upgrades to functionality on the NaviNet web portal. As we prepare to release additional system enhancements in the coming months, we will continue to look for new opportunities to improve your experience.

With the new system in place, we will begin to reinforce our self-service requirements.

Beginning October 15, 2018, all participating providers will be required to submit their initial authorization requests through the Authorizations transaction on NaviNet.

The following services must be requested through NaviNet:

  • Ambulance (Land) ? non-emergency ambulance transportation
  • Chemotherapy
  • Durable medical equipment (DME) ? purchase and rental
  • ER admission
  • Home health
  • Home infusion
  • Infusion therapy
  • Medical surgical

We encourage you to review the grid below prior to October 15, 2018. The grid provides you with allowable date ranges for each authorization service type. For example, non-emergency Ambulance Land authorization requests can be submitted up to 30 days in advance of the current date or retroactively up to 2 days prior to the current date.

Service TypeFuture Date MaximumRetroactive Date Maximum
Ambulance Land30 days after current date2 days prior to current date
Chemotherapy183 days after current date2 days prior to current date
DME Purchase/Rental183 days after current date2 days prior to current date
ER Admissioncurrent date365 days prior to current date
Home Health30 days after current date2 days prior to current date
Home Infusion183 days after current date2 days prior to current date
Infusion Therapy183 days after current date2 days prior to current date
Medical Surgical183 days after current date2 days prior to current date

Please note:

  • Ambulance authorization requests may only be submitted by ambulance service providers.
  • Providers will continue to submit authorization requests to AIM Specialty Health? (AIM) and CareCore National, LLC d/b/a eviCore healthcare (eviCore), independent companies, through the current AIM and eviCore transactions.

For more information

In preparation for reinforcement of this self-service requirement, we will offer virtual refresher training sessions beginning in September 2018. Look for registration details on Independence NaviNet Plan Central in the near future.

We encourage providers to review the authorization submission practices within their office and begin adhering to this NaviNet self-service requirement in advance of October 15, 2018. Review our detailed user guides and instructional videos, which are available under the Authorization transaction resources in the NaviNet Resources section.

If you have any questions, please contact the eBusiness Hotline at 215-640-7410.

NaviNet is a registered trademark of NaviNet, Inc., an independent company.


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