Best Practices. Improve health care administration with NaviNet.

Forms

The following forms are available for providers:

The peer-to-peer process streamlines workflows, improves cost-efficiencies, and complies with accreditation requirements. To participate in the peer-to-peer process, please complete this request form.

If you are interested in having a registered nurse Health Coach work with your Pennsylvania patients, please complete a physician referral form or contact us at 1-800-313-8628.

A request form must be completed for all medications requiring prior authorization. Please click on the link below for the applicable Prior Authorization form.

Request a copy of your current or previous provider contract or fee schedule.

Order paper copies of manuals, health and wellness materials, and more. Please note that claim forms, such as the CMS-1500, are not available through the Office Administration/Patient Education Resources Order Form; they are available for purchase at many local office supply stores.

To verify member eligibility or check the status of a claim, please use the NaviNet® web portal or call 1-800-275-2583 to access the Provider Automated System.

For all other questions and inquiries, call Customer Service at 1-800-275-2583.