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
- member responsibility
- paid amount
- service codes
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 location is not yet registered,
please visit NaviNet 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.
NaviNet? is a registered trademark of NaviNet,
Inc., an independent company.