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Pre-service review for out-of-area members

The pre-service review for out-of-area members transaction allows NaviNet® web portal (NaviNet Open) users to request pre-service reviews for out-of-area members by accessing the provider portal of the member’s home plan.

Please note that users may still need to call the member’s home plan to request preapproval if the home plan does not offer the pre-service review electronically.

To access the online pre-service review:

  1. You must first log onto NaviNet Open.
  2. Select “BlueExchange® Out-of-area” from the Independence Workflows menu, and then “Pre-service Review for Out-of-area Members.”
  3. Once the required information is entered, you’ll be able to access the provider portal of the member’s home plan and request preapproval.

Please review the Pre-service Review for Out-of-Area Members Guide that explains this transaction in greater detail. The guide can be found in the NaviNet Open section of the Provider News Center.

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