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Upcoming Provider Self-Service Requirements

In our continuing efforts to provide the most current and reliable information to our providers, in the near future we will begin to 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 the Provider Automated System when calling for claim status information. The claim detail provided through either system includes specific information, such as:

• check date
• check number
• service codes
• paid amount
• member responsibility

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 training on how to access member or claim information, please call the eBusiness Provider Hotline at 215-640-7410.

Providers can also obtain this information through the Provider Automated System by calling 1-800-275-2583 and following the voice prompts.

Look for additional information on the effective date and how to use these tools in upcoming editions of Partners in Health Update.