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NaviNet Customer Care:
1-888-482-8057.

NaviNet Transaction Changes

The NaviNet web portal is undergoing a series of changes and enhancements that will affect your day-to-day operations. Beginning September 27, 2013, IBC providers will see a difference in the look and feel of the provider portal, as well as in transaction functionality.

Given the significant number of changes to be implemented, we urge you to visit the Provider News Center for more information, including updated NaviNet User Guides and an archive of all communications.

NaviNet Transaction Changes

NaviNet® Registered Users

IBC provides a variety of resources and information to ensure that you and your staff are comfortable with NaviNet.

User Guides

IBC and NaviNet have worked together to create a variety of helpful user guides that provide easy step-by-step instructions for completing tasks and transactions via NaviNet.

Once you have logged onto NaviNet and opened the IBC Plan Central page, scroll down to the bottom of the page until you see the “Administrative Tools and Resources” section. From here you will be able to download a variety of user guides covering such topics as Electronic Funds Transfer (EFT), Rejected Claims Status Inquiries, Claims INFO Adjustment Inquiries, Chemotherapy/Infusion and Home Infusion Authorizations, and more.

In addition, user guides are also accessible under the Customer Support tab along the top of the NaviNet portal page.

Training

Participating provider offices can contact IBC for training. We provide NaviNet portal training over the phone and on-site for larger groups.

Provider Network Services Hotline:

  • PA & DE providers: 215-640-7410
  • NJ providers: 609-662-2565

Provider Self-Service Requirements

IBC-participating providers must use the NaviNet web portal or the Provider Automated System to obtain certain information. These requirements pertain to participating providers, facilities, Magellan-contracted providers, and billing agencies that support provider organizations.

Eligibility and Claims Status

All participating providers and facilities are required to use NaviNet (or call the Provider Automated System) to verify member eligibility and check IBC claims status information. The claim detail provided through either system includes specific information, such as check date, check number, service codes, paid amount, and member responsibility.

We have created a webinar that clarifies the process for obtaining member eligibility and claims status information through NaviNet.

NaviNet webinar

Claim Adjustments

Participating providers who call Customer Service to question a claim payment or to request a claim adjustment will be directed to submit the request via NaviNet using the Claim INFO Adjustment transactions.

Authorizations*

All participating providers and facilities must use NaviNet in order to initiate the following authorization types: medical/surgical procedures, chemotherapy/infusion therapy, durable medical equipment, emergency hospital admission notification, home health (dietitian, home health aide, occupational therapy, physical therapy, skilled nursing, social work, speech therapy), home infusion, outpatient speech therapy.

*This information does not apply to providers contracted with Magellan Behavioral Health, Inc. (Magellan). Magellan-contracted providers should contact their Magellan Network Coordinator at 1-800-866-4108 for authorizations.

If you have questions regarding these requirements, please contact our eBusiness Provider Hotline at 215-640-7410.

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

The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.