In our continuing efforts to provide the most current and reliable information to our network providers, as of September 15, 2011, we began enforcing our policy that requires providers to 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:
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 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 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.