Referral Submission Rules

Independence stopped accepting paper referrals with HMO/POS claims for payment. Any paper referrals submitted after this date will be returned to the issuing provider without payment.

Note: Effective for dates of services on or after January 1, 2018, we no longer require any Medicare Advantage HMO members to obtain a referral from their primary care physician (PCP) when they need to see an in-network, participating specialist. This includes all Keystone 65 Focus HMO, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Keystone 65 Basic HMO members.

PCPs
All referrals should be submitted through the NaviNet® web portal.

Specialists
Please check NaviNet to ensure that a referral was received for a member before services are rendered. Specialist are not permitted to accept paper referrals.

NaviNet registration
To register for a NaviNet account, please visit www.navinet.net and follow the prompts for provider sign-up. You may also call our Independence eBusiness Hotline at 215-640-7410.